Skip to main content

ICD-10-CM O20.0, Threatened abortion | No Prior Auth

Backwork Sign up free

Ask Backwork/O20.0

`O20.0`, Threatened abortion

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Documentation Required

Medical records must document the medical necessity of the serum magnesium test, including the signs, symptoms, and/or diagnosis that prompted the test.
Laboratories must maintain the physician's order for the serum magnesium test in their records.
Medical records must contain the serum magnesium lab test results.
When requesting individual consideration through written redetermination, providers must include all relevant medical records and supporting literature.

Key Coverage Criteria

Thyroid function testing is consideredmedically necessaryfor individuals who meet any of the following indications:
For evaluation of signs or symptoms consistent with thyroid disease;or
To evaluate, assess, or monitor confirmed or suspected thyroid disease;or
To evaluate thyroid function when there are risk factors for thyroid disease.
Evaluation of germ cell tumors;or
Testicular cancer or suspicious testicular mass;or

5 Active Policies

ANTHEM-RAD.00038, Use of 3-D, 4-D or 5-D Ultrasound in Maternity Care

ANTHEM-CG-LAB-20, Thyroid Testing

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

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

A57189, Billing and Coding: Serum Magnesium

Related Codes

Z34.00(4 policies)O16.9(4 policies)Z34.93(4 policies)O10.011(4 policies)O30.001(3 policies)O09.00(3 policies)O09.93(3 policies)O11.1(3 policies)

Have a follow-up question?

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

Ask Backwork about O20.0 Sign up free

For redetermination, providers must submit at minimum two (2) Phase II studies or one (1) Phase III study to support the request.