Does S41.159S require prior authorization?

No, S41.159S does not require prior authorization (high confidence). Covered without prior authorization.

`S41.159S`, Open bite of unspecified upper arm, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

No explicit documentation requirements (medical records, test results, prior authorization criteria) are specified in the provided document text.
No explicit documentation requirements, billing criteria, ICD-10 or CPT codes, or specific record-keeping instructions are provided in this document.
The document repeatedly calls for clinical-trial–quality documentation (well-defined end-points, power calculations, appropriate statistical methods) for future studies but does not specify documentation required for coverage.

No explicit covered indications are stated in this document. The text describes investigational/experimental uses of stem cell and cell-based therapies in multiple clinical scenarios, including:
Ischemic heart disease / acute myocardial infarction (AMI) — investigations of intracoronary or intramyocardial delivery of bone marrow mononuclear cells (BMCs/BM-MNC), mesenchymal stem cells (MSCs), cardiosphere-derived cells (CDCs), autologous skeletal myoblasts (ASM), and allogeneic MSCs.
Chronic ischemic heart disease / heart failure (including ischemic cardiomyopathy, advanced heart failure, reduced LVEF) — trials of transendocardial, intracoronary, and intramyocardial delivery of various cell types (BMC, MSC, cardiopoietic cells, CDCs, skeletal myoblasts).
Peripheral arterial disease (PAD) and critical limb ischemia (CLI) — intra-arterial or intramuscular implantation/infusion of autologous bone marrow mononuclear cells (BMMNCs / mBMCs) or peripheral blood mononuclear cells.
Dilated cardiomyopathy (DCM) — intracoronary infusion of BMMCs or BMSCs evaluated in small randomized studies.
Pediatric cardiomyopathy — small pilot intracoronary stem cell trials in children.

ANTHEM-CG-MED-73, Hyperbaric Oxygen Therapy (Systemic/Topical)

AETNA-CPB-0599, Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation

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