Does C79.32 require prior authorization?

No, C79.32 does not require prior authorization (high confidence). Code is covered without prior authorization.

`C79.32` — Secondary malignant neoplasm of cerebral meninges

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Submit the appropriate CPT code for the KRAS test and enter 1 unit of service (UOS) on the claim.
Include the assigned DEX Z-Code™ identifier in the comment/narrative field for Part B electronic claims (Loop 2400 or SV101-7 for 5010A1 837P) or on an attachment for paper Part B claims.
For Part A claims, enter the assigned DEX Z-Code™ identifier adjacent to the CPT code in the comment/narrative field (Line SV202-7 for 837I electronic claims or Block 80 for the UB04 form).
Labs may use SV101-7, SV202-7 (preferred), or the NTE field to submit the required information when reporting the KRAS test on electronic claims.

therascreen® KRAS test: detection of somatic KRAS mutations to identify colorectal cancer (CRC) patients for treatment with cetuximab (Erbitux®).
cobas® KRAS test: detection of KRAS mutations in codons 12 and 13 to identify colorectal cancer (CRC) patients for treatment with cetuximab (Erbitux®) or panitumumab (Vectibix®).
Fundus photography is covered when medical necessity is documented in the medical record, including relevant history, exam, diagnostic test results, and retention of the photographs and an interpretation/report.
Extended ophthalmoscopy is covered when medical necessity is documented for each eye, including relevant history, physical exam, pertinent diagnostic results, and retinal drawings that meet the policy specifications.
Patients actively receiving intravitreal injections for exudative age-related macular degeneration (ICD H35.3210-H35.3213, H35.3220-H35.3223, H35.3230-H35.3233) may require and are covered for extended ophthalmoscopy.
Conditions including tuberculosis of eye (A18.53, A18.54), diabetes mellitus with ophthalmic complications (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359), ophthalmia nodosa (H16.241-H16.249), selected anterior segment disorders (H20.00-H21.1X1), and transient cerebral ischemic attacks with ocular involvement (G45.3) may require extended ophthalmoscopy and are covered.

L38678 — MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells

J05

A55162 — Billing and Coding: MolDX: FDA-Approved KRAS Tests

J05

L36797 — MolDX: NRAS Genetic Testing

J05

L34623 — Intraoperative Neurophysiological Testing

J05

L34624

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