Does D06.9 require prior authorization?

No, D06.9 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D06.9` — Carcinoma in situ of cervix, unspecified

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
When billing J7999-KD, enter the name and total dose (mg or mcg) of each drug in Box 19 of the CMS-1500 or the appropriate electronic comment loop; if Box 19 cannot accommodate all information, attach the details to the paper claim.
If a portion of a single-dose vial is not used, submit the HCPCS code for the drug on a separate claim line and append modifier JW to indicate discarded/unused portion.
Separate payment may be made for pump refilling and/or adjustments; submit these services using the appropriate drug refill or maintenance CPT/HCPCS code that accurately describes the service rendered.

Compounded medications for use in implantable infusion pumps may be covered by Medicare when their use meets all other criteria for services provided incident to a physician's service.
True off-the-shelf (non‑compounded) drugs used without compounding and administered via DME may be billed using the drug-specific HCPCS code and are reimbursed under CMS ASP methodology.
If Prialt® is implanted as a single agent in the pump, bill using HCPCS code J2278-KD.
Compounded single-agent or combination drug formulations used in implanted infusion pumps must be billed using HCPCS code J7999-KD for reimbursement.
Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
Implantable infusion pumps and associated services are covered when used for conditions listed in the CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 4, §280.14 (Infusion Pumps).

CIGNA-CPG030 — Low-Level Laser and High-Power Laser Therapy - (CPG030)

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

AETNA-CPB-0779 — Plerixafor

A56421 — Billing and Coding: CT of the Abdomen and Pelvis

A56695 — Billing and Coding: Implantable Infusion Pump

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