Does R90.89 require prior authorization?

No, R90.89 does not require prior authorization (high confidence). Covered without prior authorization.

`R90.89`, Other abnormal findings on diagnostic imaging of central nervous system

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
Medical records must include history and physical notes, laboratory results, and documentation of signs and symptoms that warrant the head/neck diagnostic imaging.

CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
Flow cytometry is covered for examination of body fluids (including peripheral blood and cerebrospinal fluid), bone marrow, and lymphoreticular tissues (lymph nodes, tonsil, spleen).
Peripheral blood and fine needle aspirate specimens are acceptable for flow cytometry to avoid more invasive diagnostic procedures.
Coverage decisions are governed by the associated Local Coverage Determination LCD L34215 and its specific coverage criteria.
Lumbar puncture (CSF testing) to confirm presence of elevated phosphorylated tau (P-tau) and/or elevated total tau (T-tau) and reduced beta amyloid-42 (Aβ42) or a low Aβ42/Aβ40 ratio as determined by the lab assay detected in cerebrospinal fluid (CSF) for the assessment of mild cognitive impairment (MCI) when Alzheimer's disease (AD) is suspected.

ANTHEM-CG-LAB-20, Thyroid Testing

AETNA-CPB-0349, Alzheimer's Disease Tests

A56421, Billing and Coding: CT of the Abdomen and Pelvis

A56580, Billing and Coding: Computerized Axial Tomography (CT), Thorax

A57204, Billing and Coding: MRI and CT Scans of the Head and Neck

A57689, Billing and Coding: Lab: Flow Cytometry