Does T71.123A require prior authorization?

No, T71.123A does not require prior authorization (high confidence). Covered without prior authorization.

`T71.123A`, Asphyxiation due to plastic bag, assault, initial 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.
Follow LCD L35434 for reasonable and necessary requirements and supporting medical documentation for oximetry services.
Report overnight oximetry using CPT code 94762 on claims.
An interpretation and report must be a complete, separately identifiable written report addressing findings, relevant clinical issues, comparative data (when available), and must be included in the medical record.

An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient.
A separate ECG on the same day as a cardiac stress test is payable only when it provides additional clinically necessary information beyond the stress test (e.g., to rule out acute myocardial infarction prior to performing the stress test).
Rhythm ECGs are covered when used to evaluate signs or symptoms suggesting a cardiac rhythm disorder.
Home-based ECG services (including additional payment above the base ECG amount for transportation) are covered when there is a documented medical need to perform the ECG in the patient's home, typically for homebound or bed-confined patients.
A second professional component (PC) interpretation may be paid when a second physician’s substantially greater expertise is necessary and reasonable to clarify a questionable or confusing ECG finding and contributes substantially to diagnosis or treatment.
Oximetry is medically necessary for patients exhibiting acute respiratory dysfunction signs or symptoms (tachypnea, dyspnea, cyanosis, respiratory distress, confusion, or hypoxia).

NOVITAS-JH-L35434, Oximetry Services

NOVITAS-JL-L35434, Oximetry Services

A57205, Billing and Coding: Oximetry Services

A56612, Billing and Coding: CT of the Head

A57326, Billing and Coding: Electrocardiograms

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