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ICD-10-CM P35.9, Congenital viral disease, unspecified | No Prior Auth

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`P35.9`, Congenital viral disease, unspecified

ICD-10-CM

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Key Coverage Criteria

Fundus photography is consideredmedically necessaryto document abnormalities or disease processes (not screening) affecting the eye or to follow the progress of such eye disease when the results of fundus photography will be used to direct therapy and improve clinical outcomes. [...]
Diabetic retinopathy
To further evaluate or monitor glaucoma or glaucoma suspects
Retinal detachment and defects
Further evaluation of an abnormal electro-oculogram (EOG) or oculomotor studies
To further evaluate color vision deficiency

1 Active Policy

ANTHEM-CG-MED-47, Fundus Photography

Related Codes

92499(1 policies)A18.50(1 policies)A18.59(1 policies)A50.01(1 policies)A50.30(1 policies)A50.44(1 policies)A51.43(1 policies)92250(1 policies)

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