Does R82.991 require prior authorization?

No, R82.991 does not require prior authorization (high confidence). Covered without prior authorization.

`R82.991`, Hypocitraturia

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Medical records must document that the ultrasound was limited to retroperitoneal structures when billing CPT 76770/76775/76776, including images/findings demonstrating limitation to the retroperitoneum.
If the exam was expanded to include organs outside the retroperitoneum, documentation must reflect the expansion and support billing a full or limited abdominal ultrasound (CPT 76700/76705/76706).
Claims and documentation should follow the complementary Local Coverage Determination L34577 and any applicable LCD requirements.
ICD-10 R82.991 - R82.998 are listed as 'covered if selection criteria are met' — selection criteria are referenced but not detailed in the document.

Retroperitoneal ultrasound (CPT 76770, 76775, 76776) is covered when the exam is limited solely to retroperitoneal structures.
A full (complete) or limited abdominal ultrasound (CPT 76700, 76705, 76706) is covered when the exam includes organs or structures outside the retroperitoneum or when primary findings involve non-retroperitoneal structures (e.g., gallbladder, liver, spleen, common bile duct).
ICD-10 codes R82.991 - R82.998 (Other abnormal findings in urine) are listed as "ICD-10 codes covered if selection criteria are met" (selection criteria not specified in the CPB).
ICD-10 codes R82.991 - R82.998 (Other abnormal findings in urine) covered if selection criteria are met
Note: The policy does not state any metabolic or environmental profiling methods as covered for assessment of kidney stone risk; instead these are listed as experimental and investigational (see Limitations).

AETNA-CPB-0392, Kidney Stones: Selected Interventions

A55336, Billing and Coding: Retroperitoneal Ultrasound

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