Does S34.9XXA require prior authorization?

No, S34.9XXA does not require prior authorization (high confidence). Covered without prior authorization.

`S34.9XXA`, Injury of unspecified nerves at abdomen, lower back and pelvis level, initial encounter

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Medical records must be maintained and available upon request; every page must be legible and include patient identification (e.g., full name, dates of service) and identify the physician or non-physician practitioner responsible for care.
Submitted medical records must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Claims and documentation requirements for CPNB are governed by and must follow the Local Coverage Determination L37641 referenced by this guideline.

Regional or local nerve blocks performed as an adjunct to, or as the sole means of, regional/local anesthesia for an operative procedure are not affected by this noncoverage policy (i.e., such intraoperative regional/local anesthesia is allowed).
No specific coverage indications are stated in this billing/coding guideline; refer to Local Coverage Determination L37641 for covered indications for continuous peripheral nerve blocks (CPNB).
NC-stat testing (CPT 95905) is allowed when the beneficiary has a high pre-test or prior probability of Carpal Tunnel Syndrome (CTS), limited to one service per arm.
Use CPT 95870 for sampling muscles other than the paraspinals associated with the extremities that have been tested.
Nerve conduction studies (NCS) are indicated for localization of focal neuropathies or compressive lesions such as carpal tunnel syndrome, ulnar neuropathies, and nerve root lesions.
NCS are indicated for diagnosis and prognosis of traumatic peripheral nerve lesions.

NGS-J6-L35098, Nerve Conduction Studies and Electromyography

A57668, Billing and Coding: Nerve Conduction Studies and Electromyography

NGS-JK-L35098, Nerve Conduction Studies and Electromyography

A56034, Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy

A56607, Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)