Does N70.03 require prior authorization?

No, N70.03 does not require prior authorization (high confidence). Covered without prior authorization.

`N70.03`, Acute salpingitis and oophoritis

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
Cross-reference: criteria related to cryopreservation are addressed in CP.MP.55 Assisted Reproductive Technologies (see that policy for cryopreservation requirements).
For individuals with a female reproductive system aged ≥40 requesting retrieval of their own oocytes, documentation that the treating provider has evaluated: age, infertility risk factors, and a measure of ovarian reserve, and that the provider considers use of the member's own oocytes a viable strategy for attempting future conception.
Documentation that the planned treatment causing risk to fertility is medically necessary.

Patients undergoing bilateral oophorectomy with risk of loss of fertility.
Patients receiving gonadotoxic therapy (e.g., alkylating agents) with risk of infertility.
Patients receiving cytotoxic chemotherapy that may impair future fertility.
Patients receiving radiation therapy with potential gonadal exposure risking fertility loss.
Patients with other iatrogenic causes that may transiently or permanently affect fertility.
Ovarian stimulation and retrieval of oocytes for adults and adolescents with a female reproductive system prior to commencing medically necessary treatment likely to cause infertility (excluding voluntary sterilization).

AMBETTER-CP.MP.130, Fertility Preservation

REGENCE-SUR218, Hysterectomy

A56421, Billing and Coding: CT of the Abdomen and Pelvis

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