A39.84 — Postmeningococcal arthritis
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Claims for arthroscopic lavage/drainage for infection should be billed using CPT 29871 and reference NCD 150.9.
- Policy cites NCD 150.9 and CMS Change Request 3281; any additional documentation or contractor-specific requirements are determined by the Medicare contractor.
- Medical records must include history and physical notes, laboratory results, and documentation of signs and symptoms that warrant the head/neck diagnostic imaging.
- Accurate HCPCS/CPT coding must be submitted to differentiate CT and MRI scans from other radiology services and to support coverage determinations.
Key Coverage Criteria
- All other indications for arthroscopic lavage of the knee are subject to Medicare contractor discretion.
- Arthroscopic lavage and drainage of the knee for infection (septic arthritis) is covered and described by CPT 29871 per NCD 150.9.
- CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
- Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
- G71.21 | Nemaline myopathy
- G83.0 | Diplegia of upper limbs
6 Active Policies
A57215 — Billing and Coding: MRI and CT Scans of the Head and Neck
AETNA-CPB-0645 — Total Ankle Arthroplasty
A54061 — Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees
A57204 — Billing and Coding: MRI and CT Scans of the Head and Neck
L35175 — MRI and CT Scans of the Head and Neck
Related Codes
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