Does B45.9 require prior authorization?

No, B45.9 does not require prior authorization (high confidence). Code is covered without prior authorization.

`B45.9` — Cryptococcosis, unspecified

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and be made available to the contractor upon request.
The record must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.

Nail debridement is covered only when the service meets all indications and limitations specified in LCD L33922 and applicable CMS medical necessity and payment rules.
Nail debridement for symptomatic mycotic nails is covered when there is documented clinical evidence of mycosis and qualifying symptoms for toenail debridement.
CT thorax is covered for diagnosis and/or staging of neoplastic and hematologic processes arising in or involving the thorax.
CT thorax is covered to evaluate pulmonary, mediastinal, pleural, and chest wall infections and their complications.
CT thorax is covered to detect and characterize mediastinal neoplasms and other mediastinal processes.
CT thorax is covered for assessment of cardiopulmonary failure or insufficiency.

AETNA-CPB-0650 — Polymerase Chain Reaction Testing: Selected Indications

A56580 — Billing and Coding: Computerized Axial Tomography (CT), Thorax

A56612 — Billing and Coding: CT of the Head

A57672 — Billing and Coding: Nail Debridement

L34417 — CT of the Head

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