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ICD-10-CM S15.292S, Other specified injury of left external jugular vein, sequela | No Prior Auth

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`S15.292S`, Other specified injury of left external jugular vein, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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.
Documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

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

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.

Key Coverage Criteria

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.
Report group therapy with CPT code 92508 when patients are not receiving direct one-on-one contact and are supervised by the therapist.
Use the appropriate CPT evaluation code for re-evaluations in SLP because CPT does not define a distinct re-evaluation code.
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.

13 Active Policies

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

J6

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

J6

A57056, Billing and Coding: Aortography and Peripheral Angiography

J9

FIRST_COAST-L36767, Aortography and peripheral angiography

J9

NOVITAS-JH-L35070, Speech - Language Pathology (SLP) Services: Communication Disorders

JH

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

JH

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

JK

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

JL

NOVITAS-JL-L35070, Speech - Language Pathology (SLP) Services: Communication Disorders

JL

A54111, Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders

JL

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

JL

A56775, Billing and Coding: Magnetic Resonance Angiography

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

Related Codes

G81.11(13 policies)G81.04(13 policies)G81.01(13 policies)G45.9(13 policies)G81.02(13 policies)G81.03(13 policies)G45.8(13 policies)G81.12(13 policies)

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