Does Z79.2 require prior authorization?

No, Z79.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`Z79.2`, Long term (current) use of antibiotics

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medical records must document the medical necessity of the serum magnesium test, including the signs, symptoms, and/or diagnosis that prompted the test.
Laboratories must maintain the physician's order for the serum magnesium test in their records.
Medical records must contain the serum magnesium lab test results.
When requesting individual consideration through written redetermination, providers must include all relevant medical records and supporting literature.

CPT codes 92553, 92557, and 92568 are allowable when the beneficiary has current long-term use of ototoxic antibiotics.
The professional component (PC) of CPT codes 92537, 92538, 92541, 92542, 92544, 92545, 92546, 92587, 92588, 92651, 92652, and 92653 may be reported when the PC is performed in inpatient, outpatient, rehabilitation facilities, nursing facilities (when Part A benefits are exhausted), hearing and speech centers, independent clinics, or independent diagnostic testing facilities (IDTF).
Technical-only CPT codes 92547, 92552, 92553, 92555, 92556, 92562, 92563, 92565, 92571, 92572, 92575, 92576, 92577, 92582, 92583, and 92584 may be reported when performed in office settings, clinics, hearing and speech centers, and nursing facilities.
Payment for technical components of TC/PC services (when the PC is performed by an appropriate professional) and for technical-only services is allowed to hospitals.
Vestibular function tests and diagnostic audiometric tests are covered when performed to determine appropriate medical or surgical treatment for disorders of auditory, balance, or other neural systems.
Pure tone audiometry (air and bone), comprehensive hearing testing and acoustic reflex testing are covered for patients on continuing long-term (>14 days) use of ototoxic antibiotics (e.g., streptomycin, aminoglycosides) for ototoxicity monitoring.

NOVITAS-JH-L35007, Vestibular and Audiologic Function Studies

NOVITAS-JL-L35007, Vestibular and Audiologic Function Studies

A57434, Billing and Coding: Vestibular and Audiologic Function Studies

A57189, Billing and Coding: Serum Magnesium

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