Does L03.91 require prior authorization?

No, L03.91 does not require prior authorization (high confidence). Covered without prior authorization.

`L03.91`, Acute lymphangitis, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Routine foot care is covered only when clinical documentation demonstrates the patient’s condition warrants the provider to render the services and that failure to provide the services would be hazardous to the beneficiary due to underlying medical condition(s), per CMS Pub 100-02, Ch.15, §290.
MolecuLight, a hand-held device, for point-of-care fluorescence imaging of wounds
Noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications (e.g., bacterial infections, deep tissue pressure injury, and femoral artery thrombosis)
Warm-Up Active Wound Therapy, also known as noncontact normothermic wound therapy (NNWT) and warming therapy
None — The CPB states the following are considered experimental and investigational because effectiveness has not been established: MolecuLight (hand-held device) for point-of-care fluorescence imaging of wounds; noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications; Warm-Up Active Wound Therapy (noncontact normothermic wound therapy / NNWT / warming therapy).

NOVITAS-JH-L35138, Routine Foot Care

NOVITAS-JL-L35138, Routine Foot Care

A52996, Billing and Coding: Routine Foot Care

AETNA-CPB-0244, Skin and Soft Tissue Substitutes

AETNA-CPB-0372, Wound Imaging and Noninvasive Wound Therapy

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