Does D72.820 require prior authorization?

No, D72.820 does not require prior authorization (high confidence). Code is covered without prior authorization.

`D72.820` — Lymphocytosis (symptomatic)

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Select and report the appropriate CPT code for the NGS LDT.
Enter 1 unit of service (UOS) on the claim for the NGS LDT.
Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part B claims (Loop 2400 or SV101-7 for 5010A1 837P electronic claims; Box 19 for paper claims).
Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part A claims (Line SV202-7 for 837I electronic claims; Block 80 for the UB04 paper claim form).

Next-generation sequencing (NGS) lab-developed tests (LDTs) for myeloid malignancies and suspected myeloid malignancies are addressed by this billing/coding guidance in conjunction with LCD L38047.
Bill this policy's procedures when submitting claims for Next-Generation Sequencing (NGS) lab-developed tests (LDTs) for myeloid malignancies or suspected myeloid malignancies.
Claims for Next-Generation Sequencing (NGS) lab-developed tests (LDTs) for myeloid malignancies and suspected myeloid malignancies should be billed using the instructions below.
Next-generation sequencing (NGS) lab-developed test (LDT) performed to evaluate, diagnose, or characterize myeloid malignancies or suspected myeloid malignancies.
This billing/coding policy applies when reporting Non-Next Generation Sequencing (Non-NGS) targeted molecular panel tests performed for predictive testing in cancer.
FCM is indicated to evaluate blood, body fluids, CSF, bone marrow, lymph node, tonsil, spleen and other solid tissues for characterization of cellular populations and to avoid more invasive procedures when peripheral blood or fine needle aspirate material suffices.

A57878 — Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies

J05

L38176 — MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies

J05

L40277 — MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer

J05

A60309 — Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer

J05

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