Does R10.8A1 require prior authorization?

No, R10.8A1 does not require prior authorization (high confidence). Covered without prior authorization.

`R10.8A1`, Right flank tenderness

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Claims must include the appropriate CPT code (88120 or 88121), 1 unit of service, and an appropriate ICD-10 diagnosis code for the clinical indication.
Laboratories reporting only the technical component should append the TC modifier to CPT 88120 or 88121.
Billing entities must be CLIA certified to submit UroVysion claims and should maintain CLIA certification documentation in the medical record/claims file.
To bill a professional component, the physician must personally read, quantitate, and interpret the probe-stained cells/tissues and document that interpretive work in the medical record.

FISH bladder tumor marker testing using a validated assay (e.g., UroVysion) is covered when performed on urine specimens from persons with hematuria suspected of having bladder cancer to aid initial diagnosis.
FISH bladder tumor marker testing using a validated assay (e.g., UroVysion) is covered for monitoring tumor recurrence in patients previously diagnosed with bladder cancer using urine specimens.
Colonoscopy/sigmoidoscopy/proctosigmoidoscopy is covered for surveillance of colonic neoplasia in patients with a history of colorectal cancer or colonic polyps.
A follow-up procedure is covered 1 year after surgery for treatment of colorectal cancer when the patient is identified as high-risk for colon cancer and is eligible for continued screenings.
Non‑invasive abdominal/visceral vascular studies are covered when the test results will be used to directly inform or change the patient's clinical management.
A preoperative non‑invasive abdominal/visceral vascular study is covered as reasonable and necessary for patients undergoing bypass surgery (one preoperative scan considered reasonable).

WPS-J5-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

A57591, Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

WPS-J8-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

A56632, Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

A56421

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