E83.40 — Disorders of magnesium metabolism, unspecified
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Maintain all documentation in the patient's medical record and make it available to the contractor upon request; every page must be legible and include patient identification and dates of service.
- The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.
- The submitted medical record must support the use of the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must describe the service performed.
- If the service provider is not the ordering/referring physician, that provider must maintain hard-copy documentation of test results and interpretation plus copies of the ordering/referring physician’s order.
Key Coverage Criteria
- Parathormone (parathyroid hormone) testing is covered when medical necessity and reasonable-and-necessary criteria specified in Local Coverage Determination L34018 are met.
- For renal dialysis facilities submitting claims for parathormone testing, use diagnosis code N18.6 (end stage renal disease).
- No specific clinical indications are listed in this article; follow the Local Coverage Determination (LCD) L39400 for indications for magnesium testing or services.
- PTH testing is covered for evaluation of patients with a prior diagnosis of hyperparathyroidism or hypoparathyroidism.
- PTH testing is covered to evaluate a patient with an abnormal total serum calcium level.
- PTH testing is covered to distinguish parathyroid from non-parathyroid causes of hypercalcemia.
4 Active Policies
A57122 — Billing and Coding: Parathormone (Parathyroid Hormone)
J09
L34018 — Parathormone (Parathyroid Hormone)
J09
A59186 — Billing and Coding: Magnesium
L39400 — Magnesium
Related Codes
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