Does T17.528S require prior authorization?

No, T17.528S does not require prior authorization (high confidence). Covered without prior authorization.

`T17.528S`, Food in bronchus causing other injury, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
Claims must follow the complementary Local Coverage Determination (LCD L34430) and, when CPT 97000–97799 are used by PT/OT, must include documentation that the services meet the coverage and documentation requirements for physical or occupational therapy.
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.

Therapeutic procedures whose principal aim is to treat a respiratory impairment must be billed using HCPCS codes G0237, G0238, or G0239.
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.

A56580, Billing and Coding: Computerized Axial Tomography (CT), Thorax

A56717, Billing and Coding: Respiratory Therapy (Respiratory Care)

A56868, Billing and Coding: Outpatient Speech Language Pathology

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