Does S37.20XA require prior authorization?

No, S37.20XA does not require prior authorization (high confidence). Covered without prior authorization.

`S37.20XA`, Unspecified injury of bladder, initial encounter

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.
Follow LCD L35434 for reasonable and necessary requirements and supporting medical documentation for oximetry services.
Report overnight oximetry using CPT code 94762 on claims.
Medical records must document the signs, symptoms, diagnosis, or clinical rationale that meet one of the covered indications (e.g., acute respiratory symptoms, chronic respiratory/cardiopulmonary/neuromuscular disease and the specific reason for oximetry).

Injection of periurethral bulking agents is consideredmedically necessarywhen the individual has stress urinary incontinence (SUI) meeting one the following two criteria (A or B):
The incontinence is due to trauma or injury;or
Both of the following are true (1 and 2):
The incontinence persists despite conservative treatment for at least a sufficient duration to fully assess treatment effect*;and
One of the following is true:The incontinence is caused by intrinsic sphincter deficiency (ISD),orThe incontinence is due to urethral hypermobility in individuals with abdominal leak point less than 100 cm H2O.
The incontinence is caused by intrinsic sphincter deficiency (ISD),or

NOVITAS-JH-L35434, Oximetry Services

NOVITAS-JL-L35434, Oximetry Services

A57205, Billing and Coding: Oximetry Services

ANTHEM-SURG.00010, Treatments for Urinary Incontinence

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

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