Does S44.30XA require prior authorization?

No, S44.30XA does not require prior authorization (high confidence). Covered without prior authorization.

`S44.30XA`, Injury of axillary nerve, unspecified arm, 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.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request; every page must be legible and include patient identification and dates of service.

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).
Continuous intraoperative neurophysiologic monitoring provided one-on-one in the operating room (CPT 95940) is covered when it supports the covered indications in LCD L35003.
Report continuous intraoperative neurophysiologic monitoring in the operating room (95940) in addition to monitoring services provided from outside the operating room (G0453); coverage includes interpretation of baseline studies and removal of electrodes at the end of the procedure when supporting the LCD indications.
Reimbursement may be made for covered intraoperative monitoring when performed at POS 19, POS 21, POS 22, or POS 24.
Somatosensory testing is covered when it is medically necessary, ordered by a referring/ordering physician, and the medical record documents relevant history, physical exam, and pertinent diagnostic tests supporting the need for the test.

CGS-J15-L35906, Somatosensory Testing

J15

CGS-J18-L35906, Somatosensory Testing

J18

NOVITAS-JH-L35003, Intraoperative Neurophysiological Testing

A56722, Billing and Coding: Intraoperative Neurophysiological Testing

NOVITAS-JL-L35003

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