Does T49.2X5A require prior authorization?

No, T49.2X5A does not require prior authorization (high confidence). Covered without prior authorization.

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`T49.2X5A`, Adverse effect of local astringents and local detergents, initial encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

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.
The patient's medical record must contain documentation that fully supports medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each claim must be submitted with ICD-10-CM code(s) that reflect the patient's condition and indicate the reason(s) the service was performed; claims without ICD-10-CM codes will be returned.

Key Coverage Criteria

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.
CPT code 86003 (RAST type test) is covered when billed for diagnostic testing, subject to the stated annual frequency limit.
Allergy testing for inhalant allergens is covered when medically necessary; evaluation may include up to 90 prick-puncture tests followed by up to 40 intracutaneous tests if prick/puncture results are negative.
Allergy testing for food sensitivity is covered when medically necessary and may require up to 40 percutaneous tests.
Multitest intracutaneous testing of up to 60 tests may be appropriate in lieu of prick-puncture testing for selected patients (for example, young children, older adults, or needle-phobic individuals).
Exceeding the stated testing parameters may be covered when preliminary testing failed and immunotherapy failed to control symptoms, provided documentation supports medical necessity.

18 Active Policies

CGS-J15-L34063, RAST Type Tests

J15

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J18-L34338, Transthoracic Echocardiography (TTE)

J18

CGS-J18-L34063, RAST Type Tests

J18

A57473, Billing and Coding: Allergy Testing

WPS-J5-L36402, Allergy Testing

NGS-J6-L33591, RAST Type Tests

A56844, Billing and Coding: RAST Type Tests

WPS-J8-L36402, Allergy Testing

NOVITAS-JH-L35049, Monitored Anesthesia Care

NGS-JK-L33591, RAST Type Tests

A57361, Billing and Coding: Monitored Anesthesia Care

NOVITAS-JL-L35049, Monitored Anesthesia Care

A57306, Billing and Coding: Transthoracic Echocardiography (TTE)

A56612, Billing and Coding: CT of the Head

A59186, Billing and Coding: Magnesium

A57043, Billing and Coding: RAST Type Tests

A57181, Billing and Coding: Allergy Testing

`T49.2X5A`, Adverse effect of local astringents and local detergents, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

18 Active Policies

Related Codes

Have a follow-up question?

T49.2X5A, Adverse effect of local astringents and local detergents, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

18 Active Policies

Related Codes

Have a follow-up question?

`T49.2X5A`, Adverse effect of local astringents and local detergents, initial encounter