Does Z79.83 require prior authorization?

No, Z79.83 does not require prior authorization (high confidence). Code is covered without prior authorization.

`Z79.83`, Long term (current) use of bisphosphonates

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing and coding guidance complements Local Coverage Determination L34434; follow LCD L34434 for clinical coverage criteria and required documentation for claims.
All services billed with unlisted procedure codes must include sufficient medical records and supporting documentation to allow development and medical review.
Include relevant medical history in the medical record that supports the need for the visual field test.
The medical record must include the ordering provider’s assessment related to the patient’s complaint for the visit when visual field testing is ordered.

Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and necessary.
For diagnostic visual field tests, report the test result on the claim if known; if the result is not known, report the signs or symptoms that prompted the test.
If the service requires a referring/ordering physician, include the ordering/referring physician’s name and NPI on the claim.
Ophthalmic biometry using CPT 76519 (A-scan) or CPT 92136 (optical coherence biometry) is payable under Medicare Part B when performed for intraocular lens (IOL) power calculation.
The global service (76519 or 92136 global) is payable in the office (place of service 11) and independent clinic (49).
The technical component (TC) of CPT 76519 or 92136 is payable in the office (11), independent clinic (49), federally qualified health center (50), and rural health clinic (72).

CGS-J15-L34394, Visual Fields Testing

J15

CGS-J15-L36460, Bone Mass Measurement

J15

CGS-J15-L34181, Ophthalmic Biometry for Intraocular Lens Power Calculation

J15

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J18-L34338

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