Does 76514 require prior authorization?

No, 76514 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 76514?

Medicare facility rate: $0.89. Non-facility rate: $0.89. Work RVU: 0.14.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.14

Facility

$0.89

Non-Facility

$0.89

The medical record must include the ordering provider's assessment relevant to the patient's complaint for that visit.
The medical record must include relevant medical history related to the service.
The medical record must include results of pertinent tests and procedures; for diagnostic tests report the actual test result if known, otherwise report the symptoms prompting the test.
All office visit records and operative reports must be signed and dated; all services ordered or rendered to Medicare beneficiaries must be signed.

Corneal pachymetry (measurement of corneal thickness) is covered to evaluate patients with a diagnosis of increased intraocular pressure.
Repeat corneal pachymetry is covered after interval corneal trauma or corneal surgery to reassess corneal thickness.
Corneal pachymetry is generally covered when performed as indicated by current medical literature or accepted standards of practice for clinical management.
An IDTF must be credentialed and approved by Palmetto GBA provider enrollment to bill Medicare for a specific diagnostic procedure or material.
Additional services and supplies (e.g., radiopharmaceuticals, special contrast agents, medications) are payable to an IDTF when the diagnostic test itself is payable and the supplies are commonly separately reimbursed to a physician in an office setting.
A supervising physician for an IDTF must be licensed in the state(s) where tests are performed, enrolled in Medicare, not excluded, meet proficiency standards for tests supervised, and provide general supervision for no more than three IDTF sites.

L33630 — Corneal Pachymetry

J06

A56548 — Billing and Coding: Corneal Pachymetry

J06

L33693 — Peripheral Venous Ultrasound

J09

A53252 — Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

J12

L37371 — Electroretinography (ERG)

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