Does T78.089A require prior authorization?

No, T78.089A does not require prior authorization (high confidence). Covered without prior authorization.

`T78.089A`, Anaphylactic reaction due to eggs, unspecified, initial encounter

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

Policy references and complements Local Coverage Determination L33417 for Allergy Skin Testing; full LCD and policy text required to determine specific documentation and billing rules.
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.

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 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.
An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient.

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

A56844, Billing and Coding: RAST Type Tests

NGS-J6-L33591, RAST Type Tests

WPS-J8-L36402, Allergy Testing

NOVITAS-JH-L35049, Monitored Anesthesia Care

NGS-JK-L33591, RAST Type Tests

NGS-JK-L40329, Allergy Diagnostic Testing

NOVITAS-JL-L35049, Monitored Anesthesia Care

A57361, Billing and Coding: Monitored Anesthesia Care

A57181, Billing and Coding: Allergy Testing

A57326, Billing and Coding: Electrocardiograms

A56612, Billing and Coding: CT of the Head

A56559, Billing and Coding: Allergy Skin Testing