Does C79.60 require prior authorization?

No, C79.60 does not require prior authorization (high confidence). Code is covered without prior authorization.

`C79.60` — Secondary malignant neoplasm of unspecified ovary

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Bill Cancer TYPE ID using CPT code 81540 on claims.
Enter the DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part B electronic (Loop 2400 or SV101-7 for 5010A1 837P) and paper (Box 19) claims.
Enter the DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part A electronic (Line SV202-7 for 837I) and UB04 paper (Block 80) claims.
Enter '1' in the Days/Unit field on the claim when billing this test.

Cancer TYPE ID (RT-PCR 92-gene assay) is billed when performing oncology mRNA gene expression testing for tumors of unknown origin using CPT code 81540.
Cancer TYPE ID (92-gene RT-PCR assay) is billed for oncology cases of tumor of unknown origin (to assist in tumor tissue-of-origin identification).
Cancer TYPE ID (RT-PCR 92-gene assay) test may be billed when claim includes the required DEX Z-code identifier adjacent to the CPT code and appropriate ICD-10-CM diagnosis code.
Bill Cancer TYPE ID using CPT code 81540 (mRNA gene expression assay of 92 genes) for evaluation of tumors of unknown origin.
Germline testing is covered when the patient has ovarian, breast, pancreatic, or prostate cancer and meets clinical indication for immediate treatment with an FDA‑approved PARP inhibitor.
Testing for deleterious variants in homologous recombination repair (HRR) genes (e.g., BRCA1, BRCA2) is covered as an aid when results will be used to determine eligibility for PARP inhibitor therapy.

L39040 — MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

J05

L36797 — MolDX: NRAS Genetic Testing

J05

A55224 — Billing and Coding: MolDX: Germline testing for use of PARP inhibitors

J05

A57581 — Billing and Coding: MolDX: NRAS Genetic Testing

J05

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