Does N17.1 require prior authorization?

No, N17.1 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

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`N17.1`, Acute kidney failure with acute cortical necrosis

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Documentation Required

Medical records must document that the ultrasound was limited to retroperitoneal structures when billing CPT 76770/76775/76776, including images/findings demonstrating limitation to the retroperitoneum.
If the exam was expanded to include organs outside the retroperitoneum, documentation must reflect the expansion and support billing a full or limited abdominal ultrasound (CPT 76700/76705/76706).
Claims and documentation should follow the complementary Local Coverage Determination L34577 and any applicable LCD requirements.

Key Coverage Criteria

Retroperitoneal ultrasound (CPT 76770, 76775, 76776) is covered when the exam is limited solely to retroperitoneal structures.
A full (complete) or limited abdominal ultrasound (CPT 76700, 76705, 76706) is covered when the exam includes organs or structures outside the retroperitoneum or when primary findings involve non-retroperitoneal structures (e.g., gallbladder, liver, spleen, common bile duct).
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.
MRA of the renal arteries and aortoiliac arteries (in the absence of AAA or aortic dissection) is covered when MRA is expected to avoid CA, physician history/physical and standard assessments are insufficient, and obtaining MRA has a high probability of positively affecting patient management.

20 Active Policies

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

A58207, Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection

WPS-J5-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

A57591, Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

NGS-J6-L33627, Non-Invasive Vascular Studies

NGS-J6-L33633, Magnetic Resonance Angiography (MRA)

A56747, Billing and Coding: Magnetic Resonance Angiography (MRA)

A56758, Billing and Coding: Non-Invasive Vascular Studies

WPS-J8-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

NOVITAS-JH-L34865, Magnetic Resonance Angiography (MRA)

NOVITAS-JH-L35049, Monitored Anesthesia Care

NGS-JK-L33633, Magnetic Resonance Angiography (MRA)

NGS-JK-L33627, Non-Invasive Vascular Studies

A57361, Billing and Coding: Monitored Anesthesia Care

A56805, Billing and Coding: Magnetic Resonance Angiography (MRA)

NOVITAS-JL-L35049, Monitored Anesthesia Care

NOVITAS-JL-L34865, Magnetic Resonance Angiography (MRA)

A59186, Billing and Coding: Magnesium

A55336, Billing and Coding: Retroperitoneal Ultrasound

`N17.1`, Acute kidney failure with acute cortical necrosis

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

N17.1, Acute kidney failure with acute cortical necrosis

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`N17.1`, Acute kidney failure with acute cortical necrosis