Does D13.2 require prior authorization?

No, D13.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D13.2` — Benign neoplasm of duodenum

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583.
T82.535S | Leakage of umbrella device, sequela
M84.38XP | Stress fracture, other site, subsequent encounter for fracture with malunion
M84.38XS | Stress fracture, other site, sequela
M84.451A | Pathological fracture, right femur, initial encounter for fracture
S32.2XXD | Fracture of coccyx, subsequent encounter for fracture with routine healing

A57484 — Billing and Coding: Vitamin D Assay Testing

J05

L34658 — Vitamin D Assay Testing

J05

L36850 — Peripheral Nerve Blocks

J06

A57452 — Billing and Coding: Peripheral Nerve Blocks

J06

L33583 — Diagnostic and Therapeutic Esophagogastroduodenoscopy

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