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ICD-10-CM S27.60XD, Unspecified injury of pleura, subsequent encounter | No Prior Auth

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`S27.60XD`, Unspecified injury of pleura, subsequent encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
Claims must follow the complementary Local Coverage Determination (LCD L34430) and, when CPT 97000–97799 are used by PT/OT, must include documentation that the services meet the coverage and documentation requirements for physical or occupational therapy.

Key Coverage Criteria

Therapeutic procedures whose principal aim is to treat a respiratory impairment must be billed using HCPCS codes G0237, G0238, or G0239.

2 Active Policies

A56580, Billing and Coding: Computerized Axial Tomography (CT), Thorax

A56717, Billing and Coding: Respiratory Therapy (Respiratory Care)

Related Codes

A15.7(2 policies)A31.0(2 policies)A15.5(2 policies)A15.6(2 policies)A15.8(2 policies)A22.1(2 policies)A15.0(2 policies)A37.01(2 policies)

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