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ICD-10-CM Q89.2, Congenital malformations of other endocrine glands | No Prior Auth

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`Q89.2`, Congenital malformations of other endocrine glands

ICD-10-CM

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Documentation Required

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification (e.g., complete name and dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Key Coverage Criteria

Ultrasound of soft tissues of the head and neck is covered when it is reasonable and necessary as defined by Local Coverage Determination L34027.
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.
Evaluation of abnormalities in the tissues or organs of the head and neck (e.g., palpable masses).

3 Active Policies

FIRST_COAST-L34027, Ultrasound, Soft Tissues of Head and Neck

J9

A57029, Billing and Coding: Ultrasound, Soft Tissues of Head and Neck

J9

ANTHEM-CG-LAB-20, Thyroid Testing

Related Codes

Z92.3(3 policies)D49.7(3 policies)E07.9(3 policies)R90.0(3 policies)C74.00(2 policies)C74.01(2 policies)C74.02(2 policies)C49.0(2 policies)

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The submitted CPT/HCPCS code must accurately describe the ultrasound service performed.

Clinical indication must be documented in the medical record (e.g., palpable mass, abnormal imaging findings, personal/family history of thyroid malignancy, suspected nodal metastases, nodule follow-up, or need for localization for a procedure).