Does R40.2410 require prior authorization?

No, R40.2410 does not require prior authorization (high confidence). Covered without prior authorization.

`R40.2410`, Glasgow coma scale score 13-15, unspecified time

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
Medical necessity for each test must be documented in the patient's medical record as required by LCD L35006.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request; every page must be legible and include patient identification and dates of service.
Documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.

Urine drug testing (UDT) and drugs-of-abuse testing are covered when reasonable and necessary per LCD L35006 and ordered on an individual patient basis by the treating clinician with medical-record documentation of medical necessity.
Patients with a documented diagnosis consistent with substance use disorder (SUD) may qualify for an exception to the standard presumptive UDT annual limits.
Coverage indications for somatosensory testing follow the Local Coverage Determination L34433; this article provides billing and coding guidance only.
Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:
Clinical signs or symptoms suggesting urinary tract infection (UTI);or
Abnormal urinalysis suggesting UTI;or

NOVITAS-JH-L35006, Controlled Substance Monitoring and Drugs of Abuse Testing

NOVITAS-JL-L35006, Controlled Substance Monitoring and Drugs of Abuse Testing

A56645, Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing

ANTHEM-CG-LAB-24, Outpatient Urine Culture

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