Does T78.2XXD require prior authorization?

No, T78.2XXD does not require prior authorization (high confidence). Covered without prior authorization.

`T78.2XXD`, Anaphylactic shock, unspecified, subsequent 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.
Supporting documentation must demonstrate that CPT 31720 was personally performed by the physician or qualified NPP when billing that code.
For consecutive days of respiratory therapy, the medical record must document why the patient was not transferred to a higher level of care.

CPT 94762 is medically necessary when intermittent arterial blood gas sampling is likely to miss important variations in the patient's respiratory status.
CPT 94762 is medically necessary when the patient has hypoxemia and there is a need to assess supplemental oxygen requirements and/or a therapeutic oxygen regimen.
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.
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.

A56844, Billing and Coding: RAST Type Tests

NGS-J6-L33591, RAST Type Tests

NOVITAS-JH-L35049, Monitored Anesthesia Care

NGS-JK-L33591, RAST Type Tests

NOVITAS-JL-L35049, Monitored Anesthesia Care

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