Does Z91.048 require prior authorization?

No, Z91.048 does not require prior authorization (high confidence). Covered without prior authorization.

`Z91.048`, Other nonmedicinal substance allergy status

ICD-10-CM

No Prior Auth Required

Covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (for example, full name and 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).

Magnetic resonance angiography (MRA) is covered only when the service meets the reasonable and necessary coverage criteria specified in Local Coverage Determination L34865.
RAST type tests are covered when medically necessary and supported by the related Local Coverage Determination (LCD) and current medical literature or standards of practice.
CPT code 86003 (RAST type test) is covered when billed for diagnostic testing, subject to the stated annual frequency limit.
Allergy testing is covered when the patient has clinically significant allergic symptoms and conservative therapy has failed.
Allergy testing includes performance, evaluation, and reading of cutaneous and mucous membrane tests together with physician history (including immunologic history), physical examination, antigen selection, and interpretation of results.
Standard skin testing is the preferred method when allergy testing is necessary.

CGS-J15-L40325, Allergy Diagnostic Testing

J15

CGS-J15-L34063, RAST Type Tests

J15

CGS-J18-L40325, Allergy Diagnostic Testing

J18

CGS-J18-L34063, RAST Type Tests

J18

A57473, Billing and Coding: Allergy Testing

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