Does S52.509S require prior authorization?

No, S52.509S does not require prior authorization (high confidence). Covered without prior authorization.

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`S52.509S`, Unspecified fracture of the lower end of unspecified radius, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

Where thermography findings are discussed in studies, results are generally recommended to be correlated with alternative imaging techniques (e.g., mammography, ultrasound, MRI) — i.e., thermography should not be used as a standalone diagnostic test and correlation with standard diagnostic imaging/clinical findings is needed.
No specific documentation requirements are stated in the Clinical Policy Bulletin. (The policy does not list required medical records, test results, or clinical documentation for thermography because thermography is considered experimental/investigational and not covered for the listed indications.)

Key Coverage Criteria

No covered indications are stated in this document. (The policy background notes that, based on an OHTA study, the Health Care Financing Administration/CMS withdrew Medicare coverage of thermography.)
Dynamic infrared blood perfusion imaging (DIRI) for intra-operative and post-operative perfusion assessment is considered experimental and investigational (effectiveness not established).

None. Aetna considers thermography (including digital infrared thermal imaging, magnetic resonance (MR) thermography and temperature gradient studies) experimental and investigational for all indications because available medical literature indicates that the effectiveness of thermography as a diagnostic technique has not been established.

`S52.509S`, Unspecified fracture of the lower end of unspecified radius, sequela

Prior Authorization

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

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S52.509S, Unspecified fracture of the lower end of unspecified radius, sequela

Prior Authorization

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

`S52.509S`, Unspecified fracture of the lower end of unspecified radius, sequela