Does O99.845 require prior authorization?

No, O99.845 does not require prior authorization (high confidence). Covered without prior authorization.

`O99.845`, Bariatric surgery status complicating the puerperium

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When a referring or ordering physician is required, the referring/ordering provider's name and NPI must be reported on the claim.
For diagnostic tests, report the test result on the claim if known; if the result is not known at time of billing, report the symptoms that prompted the test.
Diagnosis code(s) on the claim must best describe the patient's condition for which the Vitamin D assay was performed.
All services and procedures performed on the same day for the same beneficiary by the same physician/provider should be billed on the same claim (use appropriate claim form and fields per CMS guidance).

Vitamin D assay testing is payable under Medicare Part B when performed in an office (POS 11), independent clinic (POS 49), Federally Qualified Health Center (POS 50), or independent laboratory (POS 81).
Non-physician practitioners (e.g., nurse practitioners, clinical nurse specialists, physician assistants) may certify, order, and establish the plan of care for Vitamin D assay testing as authorized by State law (outpatient settings other than CORFs).
Inherited disorders of vitamin D and phosphate metabolism;or
Immobilization (for example, cerebral palsy or neuromuscular disease);or
Hepatic failure (cirrhosis or chronic liver disease);or
Hypo- or hyper-calcemia;or

WPS-J5-L34658, Vitamin D Assay Testing

A57484, Billing and Coding: Vitamin D Assay Testing

WPS-J8-L34658, Vitamin D Assay Testing

ANTHEM-CG-LAB-11, Screening for Vitamin D Deficiency in Average Risk Individuals

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