B52.9 — Plasmodium malariae malaria without complication
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Fundus photography is consideredmedically necessaryto document abnormalities or disease processes (not screening) affecting the eye or to follow the progress of such eye disease when the results of fundus photography will be used to direct therapy and improve clinical outcomes. [...]
- Diabetic retinopathy
- To further evaluate or monitor glaucoma or glaucoma suspects
- Retinal detachment and defects
- Further evaluation of an abnormal electro-oculogram (EOG) or oculomotor studies
- To further evaluate color vision deficiency
1 Active Policy
ANTHEM-CG-MED-47 — CG-MED-47 Fundus Photography
Related Codes
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