G24.02 — Drug induced acute dystonia
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- 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).
Key Coverage Criteria
- 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.
- Psychiatric/psychological services are covered when there is a reasonable expectation that withdrawing treatment would cause the patient's condition to deteriorate, relapse, or require hospitalization.
- CORF social and psychological services are covered when indicated and may be provided by qualified social workers (minimum BS) or psychologists (minimum Master’s level).
- Psychiatric diagnostic procedures may be billed once per day and are covered at the outset of an illness or suspected illness, or again for a new episode after a hiatus or on (re)admission for complications of the underlying condition.
- Psychotherapy codes that include an E/M component are payable when performed by physicians, physician assistants (PA), nurse practitioners (NP), or clinical nurse specialists (CNS) and the E/M component is documented in the record.
- Interactive complexity add-on code 90785 may be reported in conjunction with specified diagnostic and psychotherapy codes when interactive complexity is present.
20 Active Policies
L34616 — Psychiatry and Psychology Services
J05
L39908 — Botulinum Toxin Injections
J05
A57480 — Billing and Coding: Psychiatry and Psychology Services
J05
L34635 — Botulinum Toxin Type A & Type B
J05
A57474 — Billing and Coding: Botulinum Toxin Type A & Type B
Related Codes
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