Does L92.0 require prior authorization?

No, L92.0 does not require prior authorization (high confidence). Code is covered without prior authorization.

`L92.0`, Granuloma annulare

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This policy provides billing, coding, and guideline information that complements the Local Coverage Determination (LCD) 'Cosmetic and Reconstructive Surgery' L33428; the full policy content is not included here, so specific documentation requirements (e.g., medical records, prior authorizations, forms) are not available in the provided excerpt.
Documentation supporting the claim must be maintained in the medical record and be available to Medicare upon request.
Each claim must be submitted with ICD-10-CM code(s) that reflect the patient's condition and reasons for the service; claims without ICD-10-CM codes will be returned.
For diagnostic tests related to the service, report the test result if known; if the result is not known, report the signs or symptoms that prompted the test.

Follow the related Local Coverage Determination (LCD) for clinical indications and medical necessity criteria for reduction mammaplasty.
Excision of a benign skin lesion is covered when there is clinical suspicion of malignancy (e.g., ICD-10-CM D48.5) documented in the medical record.
Removal is covered to address disturbance of skin sensation when documented (ICD-10-CM R20.0-R20.3, R20.8).
Removal is covered when documented objective changes (e.g., increase in size) support a diagnosis warranting excision.
Removal of a benign lesion is covered when the treating physician documents medical necessity for removal (physician judgment that lesion merits removal).
Report histopathologic examination separately when performed using CPT codes 88304-88305.

CGS-J15-L34200, Removal of Benign Skin Lesions

J15

CGS-J18-L34200, Removal of Benign Skin Lesions

J18

A56837, Billing and Coding: Reduction Mammaplasty

NGS-J6-L35001, Reduction Mammaplasty

NOVITAS-JH-L34938

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