Does T82.868S require prior authorization?

No, T82.868S does not require prior authorization (high confidence). Covered without prior authorization.

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`T82.868S`, Thrombosis due to vascular prosthetic devices, implants and grafts, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

Claims must be submitted with an ICD-10-CM code that represents the reason the procedure was performed, billed to the highest level of specificity, and linked to the appropriate CPT/HCPCS procedure code.
All documentation must be maintained in the patient's medical record, with every page legible, including appropriate patient identification and dates of service, and must include the legible signature of the physician or responsible non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

Key Coverage Criteria

Endovenous stenting is covered when used to treat severely symptomatic venous obstructions in accordance with LCD L38231.
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.
MRA of the renal arteries and aortoiliac arteries (in the absence of AAA or aortic dissection) is covered when MRA is expected to avoid CA, physician history/physical and standard assessments are insufficient, and obtaining MRA has a high probability of positively affecting patient management.
MRA of the chest is covered for diagnosis of suspected pulmonary embolism when the patient has a contraindication to receiving intravascular iodinated contrast material.

20 Active Policies

CGS-J15-L34062, Dialysis Access Maintenance

J15

CGS-J15-L34045, Non-Invasive Vascular Studies

J15

CGS-J18-L34045, Non-Invasive Vascular Studies

J18

CGS-J18-L34062, Dialysis Access Maintenance

J18

NGS-J6-L33627, Non-Invasive Vascular Studies

NGS-J6-L39995, Pharmacogenomic Testing

A56758, Billing and Coding: Non-Invasive Vascular Studies

A56747, Billing and Coding: Magnetic Resonance Angiography (MRA)

A59915, Billing and Coding: Pharmacogenomic Testing

NGS-J6-L33633, Magnetic Resonance Angiography (MRA)

A56644, Billing and Coding: Endovenous Stenting

FIRST_COAST-L40289, Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities

FIRST_COAST-L38231, Endovenous Stenting

FIRST_COAST-L39073, Pharmacogenomics Testing

FIRST_COAST-L33693, Peripheral Venous Ultrasound

FIRST_COAST-L40288, Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities

A58812, Billing and Coding: Pharmacogenomics Testing

NOVITAS-JH-L34865, Magnetic Resonance Angiography (MRA)

NOVITAS-JH-L39063, Pharmacogenomics Testing

NOVITAS-JH-L37893, Endovenous Stenting

`T82.868S`, Thrombosis due to vascular prosthetic devices, implants and grafts, sequela

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

T82.868S, Thrombosis due to vascular prosthetic devices, implants and grafts, sequela

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`T82.868S`, Thrombosis due to vascular prosthetic devices, implants and grafts, sequela