Does T40.493S require prior authorization?

No, T40.493S does not require prior authorization (high confidence). Covered without prior authorization.

`T40.493S`, Poisoning by other synthetic narcotics, assault, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and be available to the contractor upon request.
The record must identify the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

Drug testing services are covered when they meet the medical necessity and coverage indications specified in LCD L36029.
Medicare Part B will pay for drug screening services when furnished in allowed places of service: office (11), urgent care (20), independent clinic (49), FQHC freestanding (50), RHC freestanding (72), and independent laboratory (81).
Allergy testing is covered when the patient has clinically significant allergic symptoms and conservative therapy has failed.
Allergy testing includes performance, evaluation, and reading of cutaneous and mucous membrane tests together with physician history (including immunologic history), physical examination, antigen selection, and interpretation of results.
Standard skin testing is the preferred method when allergy testing is necessary.
When a percutaneous or intracutaneous single test (CPT 95004 or 95024) and sequential/incremental tests (CPT 95017, 95018, 95027) are performed the same day, both code types may be reported only if they are for different allergens or for different dilutions of the same allergen.

CGS-J15-L36029, Urine Drug Testing

J15

CGS-J18-L36029, Urine Drug Testing

J18

A57473, Billing and Coding: Allergy Testing

WPS-J5-L36402, Allergy Testing

WPS-J8-L36402, Allergy Testing

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