Does 83987 require prior authorization?

No, 83987 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 83987?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Claims must demonstrate that selection criteria are met for covered CPT codes (e.g., 91065 and 95012) — supporting clinical records, history, and relevant prior conservative treatment (such as the 2-week lactose‑free diet for HBT)
When a test is billed, the medical record should support the specific covered indication listed in the policy (e.g., lactose intolerance symptoms after dietary trial, or asthma evaluation/monitoring) and include relevant clinical notes, prior treatment documentation, diagnosis codes, and age where applicable
For studies of OSA biomarkers: OSA diagnosis confirmed with a full overnight or home-based PSG (polysomnography) was required in retained studies (Canto Gde et al 2015).
For HBT: documentation of a trial of a lactose-free diet for 2 weeks and persistence of symptoms after that trial (to justify HBT per medical necessity criteria)

Measurement of exhaled nitric oxide (FeNO) for evaluation of asthma
Hydrogen breath testing (HBT) for evaluation of suspected lactose intolerance/deficiency after a 2-week trial of a lactose-free diet and symptoms of lactose intolerance persist
Measurement of exhaled nitric oxide (FeNO) for monitoring response to long-term control therapy in members aged 5 years and older
CPT 91065 (Breath hydrogen or methane test) covered when selection criteria are met
CPT 95012 (Nitric oxide expired gas determination) covered when selection criteria are met
ICD-10 diagnoses listed as covered when selection criteria are met: E73.0–E73.9 (lactose intolerance)

AETNA-CPB-0691 — Exhaled Breath Tests

REGENCE-MED108 — Measurement of Exhaled Breath Condensates in the Diagnosis and Management of Other Respiratory Disorders

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