Does E83.822 require prior authorization?

No, E83.822 does not require prior authorization (high confidence). Code is covered without prior authorization.

`E83.822` — ENPP1 deficiency causing autosomal recessive hypophosphatemic rickets type 2

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

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.

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).
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.
PTH testing is covered to evaluate patients with clinical signs or symptoms suggestive of hyperparathyroidism (e.g., weakness, fatigue, bone pain, confusion, depression, nausea, vomiting, polyuria) when parathyroid disease is suspected.

A57122 — Billing and Coding: Parathormone (Parathyroid Hormone)

J09

L34018 — Parathormone (Parathyroid Hormone)

J09

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