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ICD-10-CM O99.810, Abnormal glucose complicating pregnancy | No Prior Auth

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`O99.810`, Abnormal glucose complicating pregnancy

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

Glycated serum protein testing (for example, hemoglobin (HbA1c), albumin, or fructosamine) testing is consideredmedically necessaryfor any of the following indications (A-F):
The individual is between the ages of 35 and 71 and has overweight or obesity*;or
The individual is of any age and is from a population with disproportionately high prevalence of diabetes mellitus**;or
Hyperglycemia has been found on other testing;or
To test individuals who are pregnant and considered to be at high risk for type 2 diabetes mellitus;or
Prior testing at least 3 months previously showed results near diabetes mellitus diagnostic thresholds;or

4 Active Policies

ANTHEM-CG-LAB-25, Outpatient Glycated Hemoglobin and Protein Testing

ANTHEM-CG-LAB-30, Outpatient Laboratory-based Blood Glucose Testing

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

A56686, Billing and Coding: HbA1c

Related Codes

O24.011(4 policies)R79.9(3 policies)O10.011(3 policies)O99.210(3 policies)R73.01(3 policies)R73.9(3 policies)E89.1(3 policies)E16.0(2 policies)

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