Does D3A.00 require prior authorization?

No, D3A.00 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D3A.00` — Benign carcinoid tumor of unspecified site

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.
All services ordered or rendered must be signed and dated in the medical record, including a signed and dated office visit record or operative report.
An Advance Beneficiary Notice (ABN), Form CMS-R-131, should be signed by the beneficiary when applicable to indicate acceptance of financial responsibility.
The patient's medical record must include the ordering provider's assessment as it relates to the patient's complaint for that visit.

Colonoscopy/sigmoidoscopy/proctosigmoidoscopy is covered for surveillance of colonic neoplasia in patients with a history of colorectal cancer or colonic polyps.
A follow-up procedure is covered 1 year after surgery for treatment of colorectal cancer when the patient is identified as high-risk for colon cancer and is eligible for continued screenings.
Peripheral nerve blocks are covered when they meet the reasonable and necessary requirements specified in LCD L33933.
CT thorax is covered for diagnosis and/or staging of neoplastic and hematologic processes arising in or involving the thorax.
CT thorax is covered to evaluate pulmonary, mediastinal, pleural, and chest wall infections and their complications.
CT thorax is covered to detect and characterize mediastinal neoplasms and other mediastinal processes.

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

A56456 — Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

A56580 — Billing and Coding: Computerized Axial Tomography (CT), Thorax

A56612 — Billing and Coding: CT of the Head

A56632 — Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

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