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ICD-10-CM P28.0, Primary atelectasis of newborn | No Prior Auth

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`P28.0`, Primary atelectasis of newborn

ICD-10-CM

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Key Coverage Criteria

Thyroid function testing is consideredmedically necessaryfor individuals who meet any of the following indications:
For evaluation of signs or symptoms consistent with thyroid disease;or
To evaluate, assess, or monitor confirmed or suspected thyroid disease;or
To evaluate thyroid function when there are risk factors for thyroid disease.
Therapeutic use of iNO is consideredmedically necessarywhen either criterion AorB is met:
Inhaled nitric oxide is consideredmedically necessaryas a component of the treatment of hypoxic respiratory failure (see definition) in neonates when the following criteria are met:The neonate was born at 34 or more weeks of gestation;andConventional therapies have failed;andNeonate does not have a congenital diaphragmatic hernia;or

2 Active Policies

ANTHEM-CG-LAB-20, Thyroid Testing

ANTHEM-CG-MED-69, Inhaled Nitric Oxide

Related Codes

P07.39(2 policies)84443(1 policies)A53.9(1 policies)A15.0(1 policies)A19.9(1 policies)A50.01(1 policies)84479(1 policies)84439(1 policies)

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