Does E71.521 require prior authorization?

No, E71.521 does not require prior authorization (high confidence). Code is covered without prior authorization.

`E71.521` — Adolescent X-linked adrenoleukodystrophy

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Refer to LCD L34975 for the detailed reasonable and necessary clinical criteria and documentation required to support coverage of NEPs.
Use CPT codes 95925, 95926, 95927, 95928, 95929, 95938, and 95939 for Somatosensory Evoked Potentials/Responses (SEPs/SERs).
Use CPT codes 92651, 92652, and 92653 for Brainstem Auditory Evoked Potentials/Responses (BAEPs/BAERs).
Use CPT code 95930 for Visual Evoked Potentials/Responses (VEPs/VERs).

Neurophysiology Evoked Potentials (NEPs) — including Somatosensory Evoked Potentials (SEPs), Brainstem Auditory Evoked Potentials (BAEPs/BAERs), and Visual Evoked Potentials (VEPs/VERs) — are covered when determined to be reasonable and necessary in accordance with LCD L34975.
Perform SEPs/SERs in the assessment of comatose patients when testing of somatosensory pathways is indicated.
Use VEPs/VERs to detect optic neuritis at an early or subclinical stage.
Perform SEPs/SERs in evaluation of myoclonus to assess somatosensory pathway involvement.
Perform SEPs/SERs for evaluation after spinal cord trauma when central somatosensory pathway injury is suspected.
Perform SEPs/SERs for degenerative, non‑traumatic spinal cord lesions (e.g., cervical spondylosis with myelopathy) when central somatosensory pathway involvement is suspected.

A56773 — Billing and Coding: Neurophysiology Evoked Potentials (NEPs)

J12

L34975 — Neurophysiology Evoked Potentials (NEPs)

J12

AMBETTER-CP.MP.134 — Evoked Potential Testing

ANTHEM-MP-A047560 — TRANS.00029 Hematopoietic Stem Cell Transplantation for Genetic Diseases and Aplastic Anemias

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