Does S91.309A require prior authorization?

No, S91.309A does not require prior authorization (high confidence). Covered without prior authorization.

`S91.309A`, Unspecified open wound, unspecified foot, initial encounter

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record, legible, include patient identification (e.g., full name, dates of service), and be made available to the contractor upon request.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
The ordering/referring physician/nonphysician practitioner must state the reason for the duplex scan in the order and provide relevant diagnostic information to the performing provider.

Duplex scan of lower extremity arteries is covered when medically necessary per LCD L33667, with the ordering/referring provider documenting signs and symptoms, relevant history (including known diagnoses and/or prior imaging) supporting evaluation of lower extremity arterial disease.
Strapping is considered medically necessary for the management of immobilization of a joint and restriction of movement with strapping tape (i.e., rigid, non-elastic or non-stretchy tape) for ANY of the following indications:
Strapping of hand or finger (CPT code 29280) for: fracture of finger
Strapping of hand or finger (CPT code 29280) for: dislocation of finger
Strapping/taping of ankle or foot (CPT code 29540) for: acute sprains and strains of ankle and foot
Strapping/taping of ankle or foot (CPT code 29540) for: dislocations of ankle and foot

A57064, Billing and Coding: Duplex Scan of Lower Extremity Arteries

CIGNA-CPG143, Strapping and Taping

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