Does T82.818A require prior authorization?

No, T82.818A does not require prior authorization (high confidence). Covered without prior authorization.

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`T82.818A`, Embolism due to vascular prosthetic devices, implants and grafts, initial encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

Billing and coding guidance for non-coronary vascular stents is dependent on the coverage indications, limitations, and medical necessity specified in the related Local Coverage Determination (LCD); consult the related LCD for the specific coverage and coding requirements.
The ordering physician/nonphysician practitioner must state the clinical indication and medical necessity for the study in the order.
The performing provider must maintain a permanent record of the performed study and interpretation, and must retain a copy of the ordering provider’s order and the test results.

Key Coverage Criteria

Non‑invasive abdominal/visceral vascular studies are covered when the test results will be used to directly inform or change the patient's clinical management.
A preoperative non‑invasive abdominal/visceral vascular study is covered as reasonable and necessary for patients undergoing bypass surgery (one preoperative scan considered reasonable).
Medically necessary follow‑up non‑invasive abdominal/visceral vascular studies after angioplasty are covered as indicated by the vascular distribution treated.
Non‑invasive abdominal/visceral vascular studies performed in the inpatient hospital (place of service 21) or emergency room (place of service 23) are permitted and are not subject to the routine once‑per‑year outpatient limitation.
Non-invasive peripheral arterial vascular studies are covered when the study results will be used in the clinical management of the patient and the medical necessity is documented in the medical record.
One preoperative non-invasive vascular scan for bypass surgery is reasonable and covered to guide surgical planning.

20 Active Policies

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J15-L33959, Cardiac Catheterization and Coronary Angiography

J15

CGS-J15-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J15

CGS-J15-L34337, Transesophageal Echocardiography (TEE)

J15

CGS-J15-L34062, Dialysis Access Maintenance

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34005, Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J18

CGS-J18-L34338, Transthoracic Echocardiography (TTE)

J18

CGS-J18-L34337, Transesophageal Echocardiography (TEE)

J18

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

CGS-J18-L33959, Cardiac Catheterization and Coronary Angiography

J18

CGS-J18-L34062, Dialysis Access Maintenance

J18

A57591, Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

WPS-J5-L35751, Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

A57593, Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies

WPS-J5-L35755, Non-Invasive Abdominal / Visceral Vascular Studies

WPS-J5-L35761, Non-Invasive Peripheral Arterial Vascular Studies

WPS-J5-L35998, Non-Coronary Vascular Stents

A57590, Billing and Coding: Non-Coronary Vascular Stents

A57594, Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

`T82.818A`, Embolism due to vascular prosthetic devices, implants and grafts, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

T82.818A, Embolism due to vascular prosthetic devices, implants and grafts, initial encounter

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`T82.818A`, Embolism due to vascular prosthetic devices, implants and grafts, initial encounter