Does M31.2 require prior authorization?

No, M31.2 does not require prior authorization (low confidence). No active coverage policies found for this code.

`M31.2`, Lethal midline granuloma

ICD-10-CM

No Prior Auth Required

No active coverage policies found for this code (low confidence)

Claims must meet the reasonable and necessary documentation requirements specified in LCD L35035; include clinical records demonstrating medical necessity per the LCD.
Follow the NCCI Coding Policy Manual (Chapters V and IX) for proper coding; retain documentation supporting compliance with NCCI edits.
When billing services that the LCD does not cover, use the appropriate Medicare modifier and document the basis for billing a non-covered service.
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.

Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.
CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
No specific clinical indications are provided in this billing and coding article; coverage criteria for amniotic and placental-derived product injections/applications for musculoskeletal non-wound indications are described in Local Coverage Determination L39116.

A59434, Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

A58893, Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

A57056, Billing and Coding: Aortography and Peripheral Angiography

A59764, Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

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