Does C8930 require prior authorization?

No, C8930 does not require prior authorization (high confidence). Code is covered without prior authorization.

`C8930` — Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The medical record must contain documentation fully supporting medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each echocardiography service requires a formal written report with interpretation retained in the record and copies of image documentation (paper or electronic) available for review.
A complete study must include M-mode and/or 2D measurements of LV end-diastolic diameter, LV end-systolic diameter, LV wall thickness, left atrial diameter, aortic valve excursion, and a qualitative description of LV function, or valid substitutes such as LV volumes, ejection fraction, and mass.

Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.
Contrast (contrast-enhanced) echocardiography is covered when conventional echocardiographic studies were inconclusive and contrast enhancement is needed to complete diagnostic evaluation.
Repeat echocardiographic studies are covered to monitor changes in cardiac structure or function when there is a change in clinical status or when disease progression is suspected.
Echocardiograms performed as part of the CAMZYOS REMS program are covered when billed with modifier KX and all REMS program requirements are met for patients with NYHA Class II–III obstructive hypertrophic cardiomyopathy (I42.1).
TTE is indicated to assess cardiac effects of systemic hypertension, including detection of left ventricular hypertrophy to guide long-term antihypertensive therapy.
TTE is indicated to evaluate ventricular function, cardiomyopathies, and heart failure when history, physical exam, or routine labs suggest or cannot exclude cardiac disease.

A56781 — Billing and Coding: Transthoracic Echocardiography (TTE)

J06

L33577 — Transthoracic Echocardiography (TTE)

J06

HUMANA-TRANSESOPHAGEAL-AND-TRANSTHORACIC-ECHOCARDIOGRAPHY-MA — Transesophageal and Transthoracic Echocardiography - Medicare Advantage

A57306 — Billing and Coding: Transthoracic Echocardiography (TTE)

L34338 — Transthoracic Echocardiography (TTE)