Does T82.09XS require prior authorization?

No, T82.09XS does not require prior authorization (high confidence). Covered without prior authorization.

`T82.09XS`, Other mechanical complication of heart valve prosthesis, sequela

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

The patient's medical record must fully document medical necessity for the cardiac catheterization and support the diagnosis and procedures billed.
Each claim must include ICD-10-CM diagnosis code(s) that accurately reflect the patient's condition and reason for the procedure and these codes must be linked to the CPT procedure codes on the claim.
When a referring/ordering physician is required, the name and NPI of the referring/ordering physician must be reported on the claim; for extra-cardiac angiographic services the treating physician's name and NPI must be submitted in items 17/17a of CMS-1500 or electronic equivalent.

Medicare Part B covers the professional component of cardiac catheterization and coronary angiography when performed in hospital inpatient and outpatient facility settings.
Diagnostic cardiac catheterization performed in an office setting (where permitted) is covered under Medicare Part B for both professional and technical components.
Global and technical component procedures are covered under Part B when performed under personal physician supervision in an IDTF, free-standing facility, physician office, or physician-directed clinic (physician present in room for entire procedure).
Transesophageal echocardiography (TEE) is indicated when transthoracic echocardiography (TTE) provides inadequate visualization of cardiac anatomy for structures normally visualized by TTE; report ICD-10-CM R93.1 or R93.8 as the primary diagnosis and the cardiac abnormality as a secondary diagnosis.
TEE is indicated when performed during an open chest (intraoperative) procedure; report ICD-10-CM Z01.89 as the primary diagnosis and the reason for the surgical procedure as the secondary diagnosis.
Use CPT 93315, 93316, or 93317 for evaluation of congenital cardiac anomalies (these codes are reserved for congenital anomalies only).

NGS-J6-L33557, Cardiac Catheterization and Coronary Angiography

NGS-J6-L33577, Transthoracic Echocardiography (TTE)

NGS-J6-L33579, Transesophageal Echocardiography (TEE)

A52850, Billing and Coding: Cardiac Catheterization and Coronary Angiography

A52868, Billing and Coding: Transesophageal Echocardiography (TEE)

A56781, Billing and Coding: Transthoracic Echocardiography (TTE)

A57179, Billing and Coding: Transesophageal Echocardiogram

FIRST_COAST-L33756, Transesophageal Echocardiogram

NGS-JK-L33579, Transesophageal Echocardiography (TEE)

NGS-JK-L33557, Cardiac Catheterization and Coronary Angiography

NGS-JK-L33577, Transthoracic Echocardiography (TTE)

A53064, Billing and Coding: Outpatient Occupational Therapy

A56625, Billing and Coding: Echocardiography

A56691, Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)

A57326, Billing and Coding: Electrocardiograms

A53057, Billing and Coding: Home Health Occupational Therapy

A53058, Billing and Coding: Home Health Physical Therapy