Does Q24.1 require prior authorization?

No, Q24.1 does not require prior authorization (high confidence). Covered without prior authorization.

`Q24.1`, Levocardia

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The medical record must document and fully support medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each claim must be submitted with ICD-10-CM code(s) that reflect the patient's condition and indicate the reason(s) the service was performed.
For diagnostic tests, report the test result if known; if the result is not available, report the presenting symptoms that prompted the test.
The study requires a formal written report containing clear identifying demographics, the name of the interpreting provider, the reason for the test(s), and an interpretive report.

Cardiac CT (CCT) or Coronary CT Angiography (CCTA) is covered when the patient's medical record documents medical necessity consistent with the indications and limitations set forth in the attached Local Coverage Determination (LCD).
Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.
Contrast (contrast-enhanced) echocardiography is covered when conventional echocardiographic studies were inconclusive and contrast enhancement is needed to complete diagnostic evaluation.
Repeat echocardiographic studies are covered to monitor changes in cardiac structure or function when there is a change in clinical status or when disease progression is suspected.
Coverage of transesophageal echocardiogram (TEE) is determined by the reasonable and necessary clinical criteria in Local Coverage Determination L33756; refer to LCD L33756 for specific covered indications.
Coverage indications for Coronary Computed Tomography Angiography (CCTA) are defined in the associated Local Coverage Determination LCD L35121; consult LCD L35121 for specific clinical criteria and medical necessity requirements.

CGS-J15-L33947, Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

J15

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J18-L34338, Transthoracic Echocardiography (TTE)

J18

CGS-J18-L33947, Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

J18

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