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ICD-10-CM P05.00, Newborn light for gestational age, unspecified weight | No Prior Auth

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`P05.00`, Newborn light for gestational age, unspecified weight

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Vitamin B12 blood testing is consideredmedically necessaryforanyof the following indications:
Alcohol dependence;or
Autoimmune condition such as intrinsic factor deficiency, thyroid disease, or pernicious anemia;or
Blood dyscrasia (for example cytopenia, leukopenia, or thrombocytopenia);or
Diabetes mellitus with neurologic symptoms;or
Disorders of sulphur amino acid metabolism;or

4 Active Policies

ANTHEM-CG-LAB-19, Laboratory Evaluation of Vitamin B12

ANTHEM-CG-LAB-20, Thyroid Testing

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

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

Related Codes

E66.9(3 policies)R73.9(3 policies)E13.9(3 policies)E66.01(3 policies)O10.011(3 policies)R73.01(3 policies)E08.00(3 policies)D53.9(2 policies)

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