D22.20 — Melanocytic nevi of unspecified ear and external auricular canal
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Maintain all documentation in the patient's medical record and make it available to the contractor upon request; every page must be legible and include patient identifiers (complete name, dates of service).
- Medical record 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 selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
- Documentation should state whether the block was performed for diagnostic or therapeutic purposes.
Key Coverage Criteria
- Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
- Molecular assays for the diagnosis of cutaneous melanoma are billable when submitted with the appropriate CPT/PLA code per these coding instructions.
- For the myPath Melanoma assay, bill with CPT 81479 for dates of service prior to 2019-07-01.
- For the myPath Melanoma assay, bill with proprietary CPT 0090U for dates of service on or after 2019-07-01.
- Other molecular assays for cutaneous melanoma may be billed using CPT 81479 only if there is no applicable CPT or PLA code for that assay.
- Molecular assays used for the diagnosis of cutaneous melanoma (melanocytic lesions) may be billed when appropriate CPT or PLA codes are reported.
13 Active Policies
L39479 — MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
J05
A59261 — Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
J05
A59109 — Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
A59163 — Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
A59179
Related Codes
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