Does S15.121S require prior authorization?

No, S15.121S does not require prior authorization (high confidence). Covered without prior authorization.

`S15.121S`, Major laceration of right vertebral artery, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

When billing these procedures after carotid endarterectomy, include the surgery date and the phrase 'carotid endarterectomy' in the claim narrative.
When reporting a reduced (unilateral/limited) service, append modifier -52 and include an explanation of the reduced service in Item 19 of the CMS-1500 form or electronic equivalent; any appropriate supporting documentation may be submitted with the claim.
Follow Novitas LCD L35397 for the reasonable and necessary documentation requirements and frequency limitations, and consult NCCI edits for correct coding combinations prior to billing Medicare.
Maintain all documentation in the patient’s medical record; every page must be legible, include patient identification (e.g., full name, dates of service), and be made available to the contractor upon request.

Non-invasive cerebrovascular arterial studies are covered when reasonable and necessary as defined by Novitas Local Coverage Determination (LCD) L35397.
Duplex post-interventional follow-up studies (typically limited and unilateral) are covered for evaluation after cerebrovascular intervention.
Vascular studies performed after carotid endarterectomy are covered when the claim includes the procedure date and the narrative 'carotid endarterectomy.'
Speech-language pathology (SLP) services for treatment or evaluation of communication disorders when determined reasonable and necessary per LCD L35070.
Selection and prescription of speech-generating devices should be billed with CPT code 92607.
Adaptation and training for speech-generating devices should be billed with CPT code 92609.

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

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

A57056, Billing and Coding: Aortography and Peripheral Angiography

FIRST_COAST-L36767, Aortography and peripheral angiography

Ask Backwork about documentation requirements, denial risks, or coverage in your state.