Does T50.994D require prior authorization?

No, T50.994D does not require prior authorization (high confidence). Covered without prior authorization.

`T50.994D`, Poisoning by other drugs, medicaments and biological substances, undetermined, subsequent encounter

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.
Medical necessity for each test must be documented in the patient's medical record as required by LCD L35006.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request; every page must be legible and include patient identification and dates of service.

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.
Cystatin C measurement is covered when performed on an adult (age >=18) patient with a creatinine-based eGFR of 45–59 ml/min/1.73 m2 and who does not have markers of kidney damage.
Cystatin C measurement is covered when the medical record documents a clear rationale that creatinine-based eGFR estimates are thought to be inaccurate and that more accurate knowledge of GFR will affect clinical decision-making or the patient’s plan of care.
Cystatin C measurement is covered for adult patients (age >=18) with creatinine-based eGFR 45–59 ml/min/1.73 m2 who do not have markers of kidney damage.
Cystatin C measurement is covered when documentation shows creatinine-based GFR estimates are believed to be inaccurate and more accurate GFR knowledge will affect clinical decision making or the patient's plan of care.

CGS-J15-L37598, Cystatin C Measurement

J15

CGS-J18-L37598, Cystatin C Measurement

J18

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

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

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

A57643, Billing and Coding: Lab: Cystatin C Measurement

A56612, Billing and Coding: CT of the Head

A56948, Billing and Coding: Lab: Cystatin C Measurement

A56988, Billing and Coding: Cystatin C Measurement