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ICD-10-CM O24.410, Gestational diabetes mellitus in pregnancy, diet controlled | No Prior Auth

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`O24.410`, Gestational diabetes mellitus in pregnancy, diet controlled

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

This article provides billing, coding and guideline information that complements Local Coverage Determination (LCD) L33431 for HbA1c; refer to LCD L33431 for clinical coverage criteria and specific documentation requirements.

Key Coverage Criteria

Suspected fetal death;
Assess amniotic fluid volume in post-term gestation.
Evaluate a pelvic mass that has been detected clinically.
Maternity ultrasound is consideredmedically necessaryforanyof the following:
Routine anatomy screen and dating:One ultrasound of a pregnant uterus per member, per routine course of care;Estimate gestational age for individuals with uncertain clinical dates.
One ultrasound of a pregnant uterus per member, per routine course of care;

2 Active Policies

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

A56686, Billing and Coding: HbA1c

Related Codes

O24.119(2 policies)O24.419(2 policies)O24.019(2 policies)O24.111(2 policies)O24.311(2 policies)O24.319(2 policies)O24.011(2 policies)O24.811(2 policies)

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