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ICD-10-CM S09.93XS, Unspecified injury of face, sequela | No Prior Auth

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`S09.93XS`, Unspecified injury of face, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Key Coverage Criteria

Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
Thyroid function testing is consideredmedically necessaryfor individuals who meet any of the following indications:
For evaluation of signs or symptoms consistent with thyroid disease;or
To evaluate, assess, or monitor confirmed or suspected thyroid disease;or
To evaluate thyroid function when there are risk factors for thyroid disease.
Therapeutic EGD is covered for removal of foreign bodies from the esophagus or stomach.

3 Active Policies

FIRST_COAST-L33583, Diagnostic and Therapeutic Esophagogastroduodenoscopy

J9

A57063, Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

J9

ANTHEM-CG-LAB-20, Thyroid Testing

Related Codes

F50.9(3 policies)R13.0(3 policies)E64.0(3 policies)F50.00(3 policies)K90.0(3 policies)K90.9(3 policies)D50.0(3 policies)R13.19(3 policies)

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The submitted CPT/HCPCS code must accurately describe the service performed.

The ordering/referring physician's medical record must clearly indicate the reason for the EGD and the EGD results must be included in the patient's medical record.