Does N39.9 require prior authorization?

No, N39.9 does not require prior authorization (high confidence). Covered without prior authorization.

`N39.9`, Disorder of urinary system, unspecified

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

None specified in the CPB. (The document does not list explicit medical record, test result, or clinical documentation requirements for coverage or for investigational determinations.)
Avian influenza A virus (H5N1): documentation of symptoms consistent with Avian influenza A virus and history of travel to or contact with persons or birds from a country with documented H5N1 avian influenza infections within 10 days of symptom onset.
Cerebrospinal fluid (CSF) pathogen panel: Member has clinical findings consistent with a central nervous system (CNS) infection (e.g., meningitis, encephalitis); and viral etiology is suspected or the CSF culture is inconclusive for pathogen etiology (i.e., viral, bacterial, fungal).
Coronavirus COVID-19 respiratory panel (up to 5 respiratory pathogens): Member has signs and symptoms of COVID-19 and test will be used to guide therapy.

Endometriosis
None explicitly listed as covered in this CPB. The policy identifies the following procedures as experimental and investigational (i.e., effectiveness not established and thus not supported by this policy): dorsal root ganglion stimulation; hypogastric plexus neurolysis for the treatment of chronic pelvic pain associated with endometriosis; peritoneal excision (stripping) for the treatment of endometriosis; uterine nerve ablation (UNA), laparoscopic uterine nerve ablation (LUNA) and presacral n [...]
Other indications related to pelvic pain addressed by selected treatments (policy scope: selected treatments for chronic pelvic pain, endometriosis, and other indications)
Acanthamoeba in corneal ulceration
Actinomyces, for identification of actinomyces species in tissue specimens
Adenovirus, to diagnose adenovirus myocarditis, and to diagnose adenovirus infection in immunocompromised hosts, including transplant recipients

ANTHEM-CG-LAB-24, Outpatient Urine Culture

AETNA-CPB-0530, Transvaginal Ultrasonography

AETNA-CPB-0650, Polymerase Chain Reaction Testing: Selected Indications

AETNA-CPB-0754, Chronic Pelvic Pain, Endometriosis, and Other Indications: Selected Treatments

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