Does R33.8 require prior authorization?

No, R33.8 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

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`R33.8`, Other retention of urine

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Documentation Required

When NCSs and NEMG are performed on the same day for the same patient they must be reported on the same claim.
When billing non-covered services/tests report unlisted neurological CPT 95999 and provide a description of the service/test in block 80 (Part A) or box 19 (Part B) or electronic equivalent; failure to include this information will result in Part A claims being returned and Part B claims rejected.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and include the legible signature of the responsible physician or non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s), the submitted CPT/HCPCS code must describe the service performed, and the record must clearly document the medical necessity, the indication for ordering the test(s), and a clear diagnostic impression.

Key Coverage Criteria

Nerve conduction studies (NCS) without needle electromyography (NEMG) are allowed for individuals being evaluated for carpal tunnel syndrome or tarsal tunnel syndrome when one of the diagnosis codes G56.01, G56.02, G56.03, G56.11, G56.12, G56.13, G56.21, G56.22, G56.23, G57.51, G57.52, or G57.53 is reported.
NCS without NEMG is allowed for individuals with significant lymphedema in the affected extremity when diagnosis code I89.0 is reported in addition to the primary diagnosis.
NCS without NEMG is allowed for individuals treated with anticoagulants when diagnosis code Z79.01 or Z79.02 is reported in addition to the primary diagnosis.
Diagnostic abdominal aortography and renal angiography are covered when they meet the reasonable and necessary clinical requirements specified in LCD L35092.
When femoral or iliac angiography is performed at the time of coronary angiography, bill using HCPCS code G0278.
Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.

20 Active Policies

CGS-J15-L34085, Post-Void Residual Urine and/or Bladder Capacity by Ultrasound

J15

CGS-J15-L34056, Urodynamics

J15

CGS-J18-L34085, Post-Void Residual Urine and/or Bladder Capacity by Ultrasound

J18

CGS-J18-L34056, Urodynamics

J18

WPS-J5-L35486

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R33.8, Other retention of urine