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ICD-10-CM S39.94XS, Unspecified injury of external genitals, sequela | No Prior Auth

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`S39.94XS`, Unspecified injury of external genitals, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

The use of scrotal ultrasound is consideredmedically necessaryfor the following conditions:
Evaluation of acute scrotal symptoms (for example, pain, swelling) and trauma;or
Evaluation of scrotal asymmetry or enlargement (including suspected hydroceles);or
Evaluation of scrotal masses;or
Detection or evaluation of varicoceles;or
Evaluation of infertility;or

1 Active Policy

ANTHEM-CG-RAD-27, Scrotal Ultrasound

Related Codes

C62.00(1 policies)C62.92(1 policies)C63.00(1 policies)C63.9(1 policies)C79.82(1 policies)D07.60(1 policies)D07.69(1 policies)76870(1 policies)

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