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ICD-10-CM N94.11, Superficial (introital) dyspareunia | No Prior Auth

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`N94.11`, Superficial (introital) dyspareunia

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

All listed documentation items are required for review; failure to submit any may affect decision outcome.
Submit history and physical/chart notes.
Document any conservative treatments provided, if applicable.
If conservative management is relatively or absolutely contraindicated, specify the contraindications.

1 Active Policy

REGENCE-SUR218, Hysterectomy

Related Codes

58152(1 policies)58180(1 policies)58260(1 policies)58262(1 policies)58267(1 policies)58270(1 policies)58275(1 policies)58150(1 policies)

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Provide clinical details of prior conservative treatments if they were tried and were ineffective or not tolerated.

If conservative management is considered unlikely to succeed, provide reasons.