Does L73.8 require prior authorization?

No, L73.8 does not require prior authorization (high confidence). Covered without prior authorization.

`L73.8`, Other specified follicular disorders

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Claims must include an ICD-10-CM diagnosis code that represents the reason for the procedure, billed to the highest level of specificity and linked to the appropriate procedure code.
Medical records must support that a surgical debridement was performed when billing surgical debridement CPT codes (11000-11012, 11042-11047).
Documentation substantiating depth of debridement is encouraged when billing CPT 11044 and may be required to support the level of surgical debridement billed.
Medical records must document the symptomatic nature of a hyperkeratotic lesion for CPT 11055-11057 to be coverable.

CPT 97597, 97598, and 97602 are appropriate for medically necessary selective or non-selective debridement of skin ulcers, circumscribed dermal infections, conditions affecting contiguous deeper structures, and removal of ground-in dirt (e.g., road abrasions) when supported by the medical record.
Surgical debridement CPT codes 11000-11012 and 11042-11047 are appropriate to report when surgical removal of devitalized tissue is performed and the CPT code selected reflects the deepest tissue type actually removed.
Paring codes CPT 11055-11057 may be used for paring/cutting of symptomatic hyperkeratosis when the medical record documents the lesion is symptomatic and thus medically necessary.
Low-frequency, non-contact, non-thermal ultrasound (MIST therapy) CPT 97610 is allowable for treatment of a qualifying wound (one 97610 service per day).
When the only service performed is non-surgical cleansing of the ulcer site with or without application of a surgical dressing, bill an appropriate Evaluation and Management (E/M) code rather than a debridement code.
Removal of acquired nevi (moles) when any of the selection criteria below are met.

AETNA-CPB-0300, Hair Analysis

AETNA-CPB-0633, Benign Skin Lesion Removal

A58565, Billing and Coding: Wound and Ulcer Care

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