Does T41.1X5D require prior authorization?

No, T41.1X5D does not require prior authorization (high confidence). Covered without prior authorization.

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`T41.1X5D`, Adverse effect of intravenous anesthetics, subsequent encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

The medical record must contain documentation fully supporting medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each echocardiography service requires a formal written report with interpretation retained in the record and copies of image documentation (paper or electronic) available for review.
A complete study must include M-mode and/or 2D measurements of LV end-diastolic diameter, LV end-systolic diameter, LV wall thickness, left atrial diameter, aortic valve excursion, and a qualitative description of LV function, or valid substitutes such as LV volumes, ejection fraction, and mass.

Key Coverage Criteria

Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.
Contrast (contrast-enhanced) echocardiography is covered when conventional echocardiographic studies were inconclusive and contrast enhancement is needed to complete diagnostic evaluation.
Repeat echocardiographic studies are covered to monitor changes in cardiac structure or function when there is a change in clinical status or when disease progression is suspected.
RAST type tests are covered when medically necessary and supported by the related Local Coverage Determination (LCD) and current medical literature or standards of practice.
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.

20 Active Policies

CGS-J15-L40325, Allergy Diagnostic Testing

J15

CGS-J18-L40325, Allergy Diagnostic Testing

J18

A57473, Billing and Coding: Allergy Testing

WPS-J5-L36402, Allergy Testing

NGS-J6-L40329, Allergy Diagnostic Testing

A59915, Billing and Coding: Pharmacogenomic Testing

NGS-J6-L33577, Transthoracic Echocardiography (TTE)

NGS-J6-L33591, RAST Type Tests

NGS-J6-L39995, Pharmacogenomic Testing

A56781, Billing and Coding: Transthoracic Echocardiography (TTE)

A56844, Billing and Coding: RAST Type Tests

WPS-J8-L36402, Allergy Testing

A58812, Billing and Coding: Pharmacogenomics Testing

FIRST_COAST-L39073, Pharmacogenomics Testing

NOVITAS-JH-L39063, Pharmacogenomics Testing

NOVITAS-JH-L35049, Monitored Anesthesia Care

NGS-JK-L40329, Allergy Diagnostic Testing

NGS-JK-L33577, Transthoracic Echocardiography (TTE)

NGS-JK-L33591, RAST Type Tests

NGS-JK-L39995, Pharmacogenomic Testing

`T41.1X5D`, Adverse effect of intravenous anesthetics, subsequent encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

T41.1X5D, Adverse effect of intravenous anesthetics, subsequent encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`T41.1X5D`, Adverse effect of intravenous anesthetics, subsequent encounter