Skip to main content

ICD-10-CM O26.831, Pregnancy related renal disease, first trimester | No Prior Auth

Backwork Sign up free

Ask Backwork/O26.831

`O26.831`, Pregnancy related renal disease, first trimester

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high 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

Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:
Clinical signs or symptoms suggesting urinary tract infection (UTI);or
Abnormal urinalysis suggesting UTI;or
Asymptomatic bacteriuria in pregnant persons;or
Bacteriuria in individuals prior to undergoing an endoscopic urologic procedure;or
Suspected interstitial cystitis or bladder pain syndrome.

2 Active Policies

ANTHEM-CG-LAB-24, Outpatient Urine Culture

A57189, Billing and Coding: Serum Magnesium

Related Codes

E09.29(2 policies)E11.29(2 policies)E08.29(2 policies)E09.21(2 policies)E10.10(2 policies)E10.29(2 policies)E08.21(2 policies)E13.21(2 policies)

Have a follow-up question?

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

Ask Backwork about O26.831 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.