Does S05.60XA require prior authorization?

No, S05.60XA does not require prior authorization (high confidence). Covered without prior authorization.

`S05.60XA`, Penetrating wound without foreign body of unspecified eyeball, initial encounter

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The diagnosis code(s) billed must best describe the patient’s condition for which the SCODI service was performed.
The patient's medical record must contain documentation that fully supports the medical necessity for SCODI services included within LCD L34380, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
For services requiring a referring or ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.

Scanning computerized ophthalmic diagnostic imaging (SCODI) is covered when the service meets the medical necessity criteria and is included within Local Coverage Determination L34380.
IVIG is covered only for indications specified as covered in the related Local Coverage Determination (LCD) and when medical necessity criteria in that LCD are met.
IVIG may be indicated for pure red cell aplasia–related anemia.
Intramuscular immune globulin (gamma globulin) is indicated for post-exposure prophylaxis to hepatitis A.
IG is indicated for measles (rubeola) post-exposure prophylaxis in susceptible patients exposed less than 3 days prior to treatment.
IG is indicated for rubella prophylaxis in a woman in early pregnancy who is exposed and lacks immunity.

WPS-J5-L34771, Immune Globulins

A57554, Billing and Coding: Immune Globulins

NGS-J6-L34380, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

A56537, Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

WPS-J8-L34771, Immune Globulins

NGS-JK-L34380, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)