Does T17.318S require prior authorization?

No, T17.318S does not require prior authorization (high confidence). Covered without prior authorization.

`T17.318S`, Gastric contents in larynx causing other injury, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Claims for swallowing studies should include documentation consistent with LCD L33449; this billing guideline is a complement to that LCD and providers should retain medical records supporting the medical necessity of the dysphagia evaluation.
Document evaluations and re-evaluations and bill re-evaluations using the evaluation CPT code (per policy guidance).
Document selection/prescription and programming/modification of speech-generating devices and use CPT 92607/92608 for selection/prescription and CPT 92609 for programming/modification on claims.
Claims and coding must follow the complementary Local Coverage Determination (LCD L34429) guidelines referenced in this policy.

Swallowing studies (videofluoroscopic or radiologic studies described by CPT 70370, 70371, or 74230) performed for evaluation or diagnosis of dysphagia are the intended covered service per this billing guideline and LCD L33449.
Coverage for programming and modification of speech-generating devices using CPT 92609.
Coverage for individual outpatient treatment of speech, language, voice, communication, and/or auditory processing disorders using CPT 92507.
Coverage for group outpatient treatment (2 or more individuals) of speech, language, voice, communication, and/or auditory processing disorders using CPT 92508.
Coverage for selection and prescription of speech-generating devices (SGDs) using CPT 92607 and 92608.
CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.

A56621, Billing and Coding: Swallowing Studies for Dysphagia

A56868, Billing and Coding: Outpatient Speech Language Pathology

A57204, Billing and Coding: MRI and CT Scans of the Head and Neck

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