Does Z77.010 require prior authorization?

No, Z77.010 does not require prior authorization (high confidence). Covered without prior authorization.

`Z77.010`, Contact with and (suspected) exposure to arsenic

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

No specific documentation requirements, prior authorization, or required medical records/test results are specified in this policy bulletin.
Note: External guidance cited (NICE 2007) recommends use only in research settings (controlled trials, closely observed case series and/or contribution to a register), which would imply research documentation if used in that context, but Aetna's CPB itself does not list documentation requirements.

None — Aetna considers Grenz ray therapy experimental and investigational for the treatment of dermatologic conditions because there is inadequate evidence in the published peer-reviewed medical literature regarding the effectiveness of Grenz ray therapy in the treatment of skin disorders.
Chelation therapy is consideredmedically necessarytreatment for individuals with relevant clinical findings suggestive of heavy metal toxicity and a probable exposure history inanyof the following conditions when confirmed by laboratory testing*:
Individuals with disorders of iron metabolism (for example, primary or secondary hemochromatosis);or
Lead overload in cases of acute or long-term lead exposure;or
Individuals with disorders of copper metabolism (for example, Wilsonâs disease);or
Arsenic, mercury, iron, copper, or gold poisoning when long-term exposure and toxicity has been confirmed;or

ANTHEM-CG-MED-90, Chelation Therapy

AETNA-CPB-0231, Grenz Ray Therapy for Skin Disorders

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