Does O08.2 require prior authorization?

No, O08.2 does not require prior authorization (high confidence). Covered without prior authorization.

`O08.2`, Embolism following ectopic and molar pregnancy

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Each claim must be submitted with ICD-10-CM code(s) that accurately reflect the patient’s condition and indicate the reason(s) the service was performed.
The medical record must include the ordering/referring provider’s name and NPI for services that require a referring/ordering physician.
The patient’s medical record should include the assessment by the ordering provider related to the patient’s complaint, relevant medical history, results of pertinent tests/procedures, and signed and dated office visit or operative reports.
For diagnostic tests, report the test result on the claim when known; otherwise report the symptoms that prompted performance of the test.

Cardiac catheterization and coronary angiography are covered when the medical record documents medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests that support the procedure.
Therapeutic procedures whose principal aim is to treat a respiratory impairment must be billed using HCPCS codes G0237, G0238, or G0239.
Therapeutic respiratory procedures (HCPCS G0237, G0238, G0239) using an individualized physical conditioning and exercise program with breathing techniques are covered for patients with documented activity limitations.
Pulmonary function tests (PFTs) represented by CPT codes 94070, 94200, 94640, 94726, 94727, and 94729 are covered when reasonable and medically necessary with supporting clinical documentation and a written order by a physician or appropriate NPP.
Spirometry (CPT 94010, 94011, 94012, 94060, 94070, 94150, 94200, 94375, 94726, 94727) is covered when clinically indicated and documented in the medical record.
Lung volume determination (CPT 94013, 94726, 94727, 94728) and diffusion capacity testing (CPT 94729) are covered when medically necessary and documented.

CGS-J15-L33959, Cardiac Catheterization and Coronary Angiography

J15

CGS-J18-L33959, Cardiac Catheterization and Coronary Angiography

J18

A56500, Billing and Coding: Cardiac Catheterization and Coronary Angiography

A56717, Billing and Coding: Respiratory Therapy (Respiratory Care)

A57189, Billing and Coding: Serum Magnesium

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