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ICD-10-CM O16.1, Unspecified maternal hypertension, first trimester | No Prior Auth

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`O16.1`, Unspecified maternal hypertension, first trimester

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Evaluation of germ cell tumors;or
Testicular cancer or suspicious testicular mass;or
Ovarian cancer;or
Pelvic mass;or
Mediastinal mass;or
Retroperitoneal mass;or

2 Active Policies

ANTHEM-CG-LAB-27, Human Chorionic Gonadotropin Testing

ANTHEM-CG-RAD-26, Maternity Ultrasound in the Outpatient Setting

Related Codes

O01.9(2 policies)O09.A0(2 policies)O00.91(2 policies)O01.0(2 policies)O02.0(2 policies)O02.9(2 policies)O00.00(2 policies)O09.A3(2 policies)

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