Does K91.2 require prior authorization?

No, K91.2 does not require prior authorization (high confidence). Covered without prior authorization.

`K91.2`, Postsurgical malabsorption, not elsewhere classified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All documentation must be maintained in the patient medical record and made available to the contractor upon request, with every page legible and including patient identification (complete name, dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Results of the vitamin D testing and the resulting treatment regimen must be documented in the patient's medical record, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures (e.g., progress notes and written laboratory reports).

25-hydroxy vitamin D testing (including fractions, if performed) is covered when deemed reasonable and necessary per Local Coverage Determination L33771.
Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
Vitamin D assay testing is payable under Medicare Part B when performed in an office (POS 11), independent clinic (POS 49), Federally Qualified Health Center (POS 50), or independent laboratory (POS 81).
Non-physician practitioners (e.g., nurse practitioners, clinical nurse specialists, physician assistants) may certify, order, and establish the plan of care for Vitamin D assay testing as authorized by State law (outpatient settings other than CORFs).
Treatment of warts (including plantar warts) on the foot is covered to the same extent as wart treatment at other anatomic sites.
Foot care services that are a necessary and integral part of otherwise covered services (e.g., diagnosis or treatment of diabetic ulcers, wounds, or infections) are covered.

CGS-J15-L33996, Vitamin D Assay Testing

J15

CGS-J15-L34246, Routine Foot Care and Debridement of Nails

J15

CGS-J18-L34246, Routine Foot Care and Debridement of Nails

J18

CGS-J18-L33996, Vitamin D Assay Testing

J18

WPS-J5-L34658

Ask Backwork about documentation requirements, denial risks, or coverage in your state.