D31.60 — Benign neoplasm of unspecified site of unspecified orbit
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
- 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 such as complete name and dates of service.
- The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
Key Coverage Criteria
- Visual field examinations are covered when reasonable and necessary as defined by Local Coverage Determination (LCD) L33766.
- Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
- Visual field examination is covered for patients with inflammation or disorders of the eyelids that may affect the visual field.
- Visual field examination is covered for patients with a documented diagnosis of glaucoma.
- Visual field examination is covered for glaucoma suspects, defined by increased intraocular pressure, inter-eye intraocular pressure asymmetry greater than 2–3 mm Hg, or optic nerve findings suspicious for glaucoma (asymmetric cupping, disc hemorrhage, absent or thinned temporal rim).
- Visual field examination is covered for patients with a documented disorder of the optic nerve, neurologic visual pathway, or retina.
6 Active Policies
A57637 — Billing and Coding: Visual Field Examination
J09
L33766 — Visual Field Examination
J09
A56612 — Billing and Coding: CT of the Head
A57788 — Billing and Coding: Peripheral Nerve Blocks
L34417 — CT of the Head
Related Codes
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