Does S06.5X5D require prior authorization?

No, S06.5X5D does not require prior authorization (high confidence). Covered without prior authorization.

`S06.5X5D`, Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent 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.
Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.
MRA of the renal arteries and aortoiliac arteries (in the absence of AAA or aortic dissection) is covered when MRA is expected to avoid CA, physician history/physical and standard assessments are insufficient, and obtaining MRA has a high probability of positively affecting patient management.

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

A56747, Billing and Coding: Magnetic Resonance Angiography (MRA)

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

A56937, Billing and Coding: Psychiatry and Psychology Services

NGS-J6-L33632, Psychiatry and Psychology Services

NGS-J6-L33633, Magnetic Resonance Angiography (MRA)

FIRST_COAST-L36767, Aortography and peripheral angiography

A57780, Billing and Coding: Psychological and Neuropsychological Tests

A57056, Billing and Coding: Aortography and Peripheral Angiography

FIRST_COAST-L34520, Psychological and Neuropsychological Tests

NOVITAS-JH-L35035, Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

NOVITAS-JH-L34865, Magnetic Resonance Angiography (MRA)

NOVITAS-JH-L34975, Neurophysiology Evoked Potentials (NEPs)

NOVITAS-JH-L35101, Psychiatric Codes

NGS-JK-L33633, Magnetic Resonance Angiography (MRA)

NGS-JK-L33632, Psychiatry and Psychology Services

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

NOVITAS-JL-L34865, Magnetic Resonance Angiography (MRA)

NOVITAS-JL-L34975, Neurophysiology Evoked Potentials (NEPs)

A56631, Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography