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ICD-10-CM S15.002D, Unspecified injury of left carotid artery, subsequent encounter | No Prior Auth

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`S15.002D`, Unspecified injury of left carotid artery, subsequent encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

Claims must meet the reasonable and necessary documentation requirements specified in LCD L35035; include clinical records demonstrating medical necessity per the LCD.
Follow the NCCI Coding Policy Manual (Chapters V and IX) for proper coding; retain documentation supporting compliance with NCCI edits.
When billing services that the LCD does not cover, use the appropriate Medicare modifier and document the basis for billing a non-covered service.

This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.

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 (for example, full name and dates of service).

Key Coverage Criteria

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.
Magnetic resonance angiography (MRA) is covered only when the service meets the reasonable and necessary coverage criteria specified in Local Coverage Determination L34865.
Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.
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.

12 Active Policies

FIRST_COAST-L33695, Non-invasive Extracranial Arterial Studies

J9

A57670, Billing and Coding: Non-invasive Extracranial Arterial Studies

J9

FIRST_COAST-L36767, Aortography and peripheral angiography

J9

A57056, Billing and Coding: Aortography and Peripheral Angiography

J9

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

JH

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

JH

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

JL

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

JL

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

JL

A56805, Billing and Coding: Magnetic Resonance Angiography (MRA)

JL

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

A56775, Billing and Coding: Magnetic Resonance Angiography

Related Codes

H34.11(12 policies)H34.03(12 policies)G45.9(12 policies)G45.8(12 policies)H34.01(12 policies)H34.02(12 policies)G45.3(12 policies)H34.12(12 policies)

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