About this policy
The following coding and billing guidance is to be used with its associated Local Coverage Determination . Documentation must be made available to Medicare upon request. Failure to do so, may result in denial of claims. Documentation of the medical necessity of the test must be retained in the ordering physician's patient medical record. Documentation should state the signs/symptoms and/or diagnosis that caused the need of the test procedure. Laboratories must maintain the record of the physician's order for the test. Medical records must contain the lab test results. When requesting an individual consideration through the written redetermination (formerly appeal) process, providers must include all relevant medical records and literature that supports the request. At a minimum two (2) Phase II studies (human feasibility studies suggesting efficacy, pilots) or one (1) Phase III study (primary evidence of safety and efficacy, pivotal) must be submitted for the Medical Director's review.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Showing the first 1,000 of 1,406 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 83735 | HCPCS | Covered |
| D56.1 | ICD10CM | Covered |
| D57.02 | ICD10CM | Covered |
| D57.1 | ICD10CM | Covered |
| D57.212 | ICD10CM | Covered |
| D57.412 | ICD10CM | Covered |
| D57.812 | ICD10CM | Covered |
| D68.8 | ICD10CM | Covered |
| D73.1 | ICD10CM | Covered |
| D73.2 | ICD10CM | Covered |
| D73.81 | ICD10CM | Covered |
| D73.89 | ICD10CM | Covered |
| E03.5 | ICD10CM | Covered |