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ICD-10-CM N99.538, Other complication of continent stoma of urinary tract | No Prior Auth

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`N99.538`, Other complication of continent stoma of urinary tract

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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.

Key Coverage Criteria

Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:
Clinical signs or symptoms suggesting urinary tract infection (UTI);or
Abnormal urinalysis suggesting UTI;or
Asymptomatic bacteriuria in pregnant persons;or
Bacteriuria in individuals prior to undergoing an endoscopic urologic procedure;or
Suspected interstitial cystitis or bladder pain syndrome.

2 Active Policies

ANTHEM-CG-LAB-24, Outpatient Urine Culture

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

Related Codes

C64.1(2 policies)D49.59(2 policies)A18.14(2 policies)A41.9(2 policies)D40.0(2 policies)D49.4(2 policies)A18.11(2 policies)K72.00(2 policies)

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