Does S35.319S require prior authorization?

No, S35.319S does not require prior authorization (high confidence). Covered without prior authorization.

`S35.319S`, Unspecified injury of portal vein, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification information (e.g., full name, dates of service).
Documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.

Duplex scanning is covered only when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33674.
Duplex scanning is covered to evaluate suspected chronic intestinal ischemia in patients with postprandial epigastric or periumbilical pain lasting 1–3 hours and associated weight loss from decreased oral intake.
Duplex scanning is covered to evaluate suspected acute intestinal ischemia in patients with acute crampy or steady epigastric/periumbilical pain with minimal abdominal exam findings and leukocytosis.
Duplex scanning is covered to evaluate possible injury to arterial inflow or venous outflow of abdominal, pelvic and/or retroperitoneal organs after trauma to those regions.
Duplex scanning is covered to evaluate suspected aneurysm of the renal artery or another visceral artery based on signs/symptoms or incidental radiologic finding.
Duplex scanning is covered to evaluate renovascular causes of uncontrolled hypertension in hypertensive patients who have failed first-line antihypertensive therapy (to rule out renal artery stenosis, renal arteriovenous fistula, or renal aneurysm).

FIRST_COAST-L33674, Duplex Scanning

A57636, Billing and Coding: Duplex Scanning

A56421, Billing and Coding: CT of the Abdomen and Pelvis

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