Does E05.00 require prior authorization?

No, E05.00 does not require prior authorization (high confidence). Code is covered without prior authorization.

`E05.00` — Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The patient's medical record must contain documentation that fully supports the medical necessity for the visual fields testing in accordance with the applicable LCD.
Documentation should include relevant medical history, a physical examination, and results of pertinent diagnostic tests or procedures supporting the need for visual fields testing.
The diagnosis code(s) reported on the claim must best describe the patient's condition for which the visual fields testing was performed.
Refer to NCCI and OPPS requirements prior to billing Medicare to ensure coding compliance and to determine any bundling or packaging edits.

Ultrasound of soft tissues of the head and neck is covered when it is reasonable and necessary as defined by Local Coverage Determination L34027.
G71.21 | Nemaline myopathy
G83.0 | Diplegia of upper limbs
H44.19 | Other endophthalmitis
H44.532 | Leucocoria, left eye
H44.533 | Leucocoria, bilateral

A57483 — Billing and Coding: Visual Fields

J05

L34615 — Visual Fields

J05

L33574 — Visual Fields Testing

J06

L39297 — Off-label Use of Rituximab and Rituximab Biosimilars

J06

A56551 — Billing and Coding: Visual Fields Testing

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