Does M79.652 require prior authorization?

No, M79.652 does not require prior authorization (low confidence). No active coverage policies found for this code.

`M79.652`, Pain in left thigh

ICD-10-CM

No Prior Auth Required

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

The patient's medical record must contain documentation that fully supports medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each claim must be submitted with ICD-10-CM codes that reflect the patient's condition and the reason for the service; claims without ICD-10-CM codes will be returned.
For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
A permanent record of the ultrasound and its interpretation must be kept in the patient's record, including images labeled with exam date, patient identification, and image orientation; documentation of variations from normal with measurements; and a formal interpretation.

Nonvascular extremity ultrasound is covered when medical necessity is documented in the patient's record, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Diagnostic nonvascular extremity ultrasound is covered when the claim includes an ICD-10-CM diagnosis code that best describes the patient's condition and the test result or the symptoms prompting the test are documented.
Electrodiagnostic testing (EMG and/or nerve conduction studies) is indicated for evaluation of suspected carpal tunnel syndrome.
EMG and/or nerve conduction studies are indicated for evaluation of suspected radiculopathy.
EMG and/or nerve conduction studies are indicated for evaluation of suspected mononeuropathy (single-nerve entrapment or injury).
EMG and/or nerve conduction studies are indicated for evaluation of suspected polyneuropathy or mononeuropathy multiplex.

CGS-J15-L35897, Nerve Conduction Studies and Electromyography

J15

CGS-J15-L34246, Routine Foot Care and Debridement of Nails

J15

CGS-J15-L34200, Removal of Benign Skin Lesions

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34200

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