Does G44.211 require prior authorization?

No, G44.211 does not require prior authorization (high confidence). Code is covered without prior authorization.

`G44.211` — Episodic tension-type headache, intractable

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

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.
Medical records must include history and physical notes, laboratory results, and documentation of signs and symptoms that warrant the head/neck diagnostic imaging.
Accurate HCPCS/CPT coding must be submitted to differentiate CT and MRI scans from other radiology services and to support coverage determinations.
Documentation and supporting information must be available to Medicare upon request.

CT or MRI scans of the head or neck are covered when the medical record documents the scan is reasonable and necessary for diagnostic evaluation.
Coverage requires documentation supporting clinical indication such as history and physical exam findings, laboratory results, and signs or symptoms that justify the diagnostic test.
G71.21 | Nemaline myopathy
G83.0 | Diplegia of upper limbs
H44.19 | Other endophthalmitis
H44.532 | Leucocoria, left eye

A59553 — Billing and Coding: Trigger Point Injections

J05

L39713 — Trigger Point Injections

J05

A59487 — Billing and Coding: Trigger Point Injections (TPI)

J06

L39662 — Trigger Point Injections (TPI)

J06

A57204 — Billing and Coding: MRI and CT Scans of the Head and Neck

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