E89.823 — Postprocedural seroma of an endocrine system organ or structure following other procedure
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
- Claims must include the documentation and coding required by LCD L34426 and applicable billing/coding guidelines (procedure codes, supporting clinical rationale, and any required authorizations), as this article supplements that LCD.
- The medical record must clearly document the necessity for the vitamin D test(s), including the clinical indication, and must document any repeat testing and the frequency of repeat testing.
- Medical records relating to the test must be made available to Medicare upon request.
Key Coverage Criteria
- Coverage for ophthalmic angiography (fluorescein and indocyanine green) is determined by the Local Coverage Determination L34426 and applies when that LCD's clinical criteria are met.
- Vitamin D assay testing is covered when the medical record documents medical necessity for the test, including the clinical reason for testing and any planned repeat testing and frequency.
- Cranial CT (with or without contrast) is covered when the patient has clinical evidence of an intracranial disorder or an established intracranial disorder/disease.
- Contrast-enhanced CT is reasonable and necessary to assess cerebral perfusion, for example in suspected or known cerebrovascular accident (CVA).
- Contrast-enhanced CT is covered to characterize a specific intracranial lesion.
- Contrast-enhanced CT is covered to detect blood–brain barrier defects such as infarcts, tumors, infection, or vasculitis.
8 Active Policies
A57736 — Billing and Coding: Vitamin D Assay Testing
J06
L37535 — Vitamin D Assay Testing
J06
A57718 — Billing and Coding: Vitamin D Assay Testing
A56612 — Billing and Coding: CT of the Head
L34426 — Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Related Codes
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