Does N99.89 require prior authorization?

No, N99.89 does not require prior authorization (high confidence). Covered without prior authorization.

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`N99.89`, Other postprocedural complications and disorders of genitourinary system

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.
No explicit medical-record documentation requirements, ICD-10 diagnoses, frequency limits, or prior authorization criteria are specified in the provided document text.
The document repeatedly notes the need for larger, rigorous trials and therefore implies that documentation of diagnosis, prior therapies, and rationale for use would be important, but no formal documentation checklist or required records are specified in the excerpt.

Clinical documentation that the patient's nausea and vomiting is unresponsive to antiemetics and other conservative therapies for: post‑operative nausea and chemotherapy‑induced nausea (i.e., documentation of trials of appropriate antiemetic therapy and other conservative treatments and their failure).

Clinical documentation that hyperemesis gravidarum is unresponsive to other conservative medical therapy (examples given: change in diet, ginger capsules, vitamin B6) when requesting coverage of PrimaBella or ReliefBand for pregnancy-related severe NV.

Key Coverage Criteria

The ReliefBand is available by prescription for the treatment of chemotherapy-induced nausea and vomiting (chemotherapy-induced NV).
The ReliefBand is available by prescription for the treatment of post-operative nausea and vomiting (PONV).
The ReliefBand is available over-the-counter for the treatment of motion sickness.
Prescription-version ReliefBand devices for the treatment of chemotherapy-induced nausea that is unresponsive to antiemetics and other conservative therapies.
Prescription-version ReliefBand devices for the treatment of post-operative nausea that is unresponsive to antiemetics and other conservative therapies.
Prescription-version PrimaBella or ReliefBand devices for treatment of hyperemesis gravidarum that is unresponsive to other conservative medical therapy (e.g., change in diet, ginger capsules, vitamin B6).

4 Active Policies

ANTHEM-SURG.00010, Treatments for Urinary Incontinence

AETNA-CPB-0446, Endoscopic Ultrasonography

AETNA-CPB-0676, Electrical Stimulation for Nausea, Vomiting, Motion Sickness and Other Selected Indications

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

`N99.89`, Other postprocedural complications and disorders of genitourinary system

Prior Authorization

Documentation Required

Key Coverage Criteria

4 Active Policies

Related Codes

Have a follow-up question?

N99.89, Other postprocedural complications and disorders of genitourinary system

Prior Authorization

Documentation Required

Key Coverage Criteria

4 Active Policies

Related Codes

Have a follow-up question?

`N99.89`, Other postprocedural complications and disorders of genitourinary system