Does Z68.31 require prior authorization?

No, Z68.31 does not require prior authorization (high confidence). Covered without prior authorization.

`Z68.31`, Body mass index [BMI] 31.0-31.9, adult

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All documentation must be maintained in the patient medical record and made available to the contractor upon request, with every page legible and including patient identification (complete name, dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Results of the vitamin D testing and the resulting treatment regimen must be documented in the patient's medical record, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures (e.g., progress notes and written laboratory reports).

25-hydroxy vitamin D testing (including fractions, if performed) is covered when deemed reasonable and necessary per Local Coverage Determination L33771.
Implantation of a hypoglossal nerve stimulator (HNS) for the treatment of obstructive sleep apnea (OSA) is billed with CPT 64582.
Revision or replacement of chest wall respiratory sensor electrode or electrode array for treatment of OSA is billed with CPT 64583.
Insertion or replacement of cranial neurostimulator pulse generator or receiver with connection to two or more electrode arrays for treatment of OSA is billed with CPT 61886.
Removal of chest wall respiratory sensor electrode or electrode array for treatment of OSA is billed with CPT 64584.
Coverage of HNS procedures is subject to the reasonable and necessary requirements specified in Local Coverage Determination L38398; refer to the LCD for clinical eligibility and additional coverage criteria.

CGS-J15-L38307, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

J15

CGS-J15-L33996, Vitamin D Assay Testing

J15

CGS-J18-L38307, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

J18

CGS-J18-L33996, Vitamin D Assay Testing

J18

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