Does Q79.63 require prior authorization?

No, Q79.63 does not require prior authorization (high confidence). Covered without prior authorization.

`Q79.63`, Vascular Ehlers-Danlos syndrome

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part B electronic claims using Loop 2400 or SV101-7 (5010A1 837P).
For Part B paper claims, enter the appropriate DEX Z-Code identifier adjacent to the CPT code in Box 19.
For Part A electronic claims (837I), enter the appropriate DEX Z-Code identifier adjacent to the CPT code on Line SV202-7.
For UB04 claims, enter the appropriate DEX Z-Code identifier adjacent to the CPT code in Block 80.

Genetic testing for heritable thoracic aortic disease is covered as defined by the MolDX Local Coverage Determination L39933.
Genetic testing for heritable thoracic aortic disease as covered under MolDX LCD L39938.
Genetic testing for heritable thoracic aortic disease when criteria of MolDX LCD L39944 are met.
Clinical indications for coverage follow the MolDX LCD L39989 (Genetic Testing in Heritable Thoracic Aortic Disease); this billing article does not define clinical eligibility.
Myopathic EDS with clinical features suggestive of the disorder (COL12A1).
Periodontal EDS with clinical features suggestive of the disorder (C1R, C1S).

CGS-J15-L39938, MolDX: Genetic Testing for Heritable Thoracic Aortic Disease

J15

CGS-J18-L39938, MolDX: Genetic Testing for Heritable Thoracic Aortic Disease

J18

A59908, Billing and Coding: MolDX: Genetic Testing in Heritable Thoracic Aortic Disease

WPS-J5-L39989, MolDX: Genetic Testing for Heritable Thoracic Aortic Disease

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