Does L74.4 require prior authorization?

No, L74.4 does not require prior authorization (high confidence). Code is covered without prior authorization.

`L74.4`, Anhidrosis

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Performing provider must maintain medical record documentation that clearly supports medical necessity for ANS testing, including test reports and interpretation.
Documentation should include relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures used to rule out more common causes of autonomic signs or symptoms.
Supportive documentation must be available upon request and maintained by the performing provider.
All equipment used for ANS testing must meet general professional standards and have Food and Drug Administration (FDA) clearance as applicable.

Autonomic Nervous System (ANS) testing is allowed once to confirm or exclude a specific autonomic disease when medically necessary.
For patients with diagnosed autonomic disorders, repeat ANS testing is allowed when there is a change in clinical status or to evaluate response to a therapeutic intervention.
Pregnant and considered to be at high risk for type 2 diabetes mellitus;or
Impaired fasting glucose has been found on other testing;or
Blood glucose testing is consideredmedically necessaryfor individuals who meet any of the following criteria (A through Q):
Signs or symptoms of either of the following:Hypoglycemia;orHyperglycemia;or

WPS-J5-L35124, Autonomic Function Testing

A57551, Billing and Coding: Autonomic Function Testing

WPS-J8-L35124, Autonomic Function Testing

ANTHEM-CG-LAB-30, Outpatient Laboratory-based Blood Glucose Testing

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