Does T43.652A require prior authorization?

No, T43.652A does not require prior authorization (high confidence). Covered without prior authorization.

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`T43.652A`, Poisoning by methamphetamines intentional self-harm, initial encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

When a limited or follow-up echocardiogram is performed, document the targeted cardiac problem/region and bill using the appropriate CPT code (93308 or 93321).
If the study is a screening exam, document and bill with the appropriate screening ICD-10 code; document any abnormal findings and use the resulting diagnosis for subsequent billing when applicable.
Document use of ultrasound contrast enhancement and its supplies separately when billed, and do not submit separate claims for diagnostic injection services integral to the contrast procedure.

Key Coverage Criteria

Follow-up or limited transthoracic echocardiography performed to evaluate a single specified cardiac problem or region must be billed with CPT 93308.
Limited Doppler/follow-up echocardiographic studies (for targeted velocity or gradient assessment) should be billed with CPT 93321 (e.g., tricuspid regurgitant velocity to estimate pulmonary artery systolic pressure or sequential transmitral velocity in mitral stenosis).
Urine drug testing (UDT) and drugs-of-abuse testing are covered when reasonable and necessary per LCD L35006 and ordered on an individual patient basis by the treating clinician with medical-record documentation of medical necessity.
Patients with a documented diagnosis consistent with substance use disorder (SUD) may qualify for an exception to the standard presumptive UDT annual limits.
Patient has a DSM-5 mental disorder diagnosis that is the reason for the ordering physician's treatment or for which the patient was hospitalized.
CPT code 86003 (RAST type test) is covered when billed for diagnostic testing, subject to the stated annual frequency limit.

20 Active Policies

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J15-L34063, RAST Type Tests

J15

CGS-J18-L34338, Transthoracic Echocardiography (TTE)

J18

CGS-J18-L34063, RAST Type Tests

J18

WPS-J5-L36402, Allergy Testing

A57473, Billing and Coding: Allergy Testing

WPS-J8-L36402, Allergy Testing

A57077, Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing

FIRST_COAST-L36393, Controlled Substance Monitoring and Drugs of Abuse Testing

NOVITAS-JH-L35006, Controlled Substance Monitoring and Drugs of Abuse Testing

NOVITAS-JH-L35434, Oximetry Services

A57205, Billing and Coding: Oximetry Services

A56645, Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing

NOVITAS-JL-L35006, Controlled Substance Monitoring and Drugs of Abuse Testing

NOVITAS-JL-L35434, Oximetry Services

A59186, Billing and Coding: Magnesium

A56625, Billing and Coding: Echocardiography

A56756, Billing and Coding: Home Health - Psychiatric Care

A57043, Billing and Coding: RAST Type Tests

A57189, Billing and Coding: Serum Magnesium

`T43.652A`, Poisoning by methamphetamines intentional self-harm, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

T43.652A, Poisoning by methamphetamines intentional self-harm, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`T43.652A`, Poisoning by methamphetamines intentional self-harm, initial encounter