G81.94 — Hemiplegia, unspecified affecting left nondominant side
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- The patient's medical record must contain documentation that fully supports the medical necessity for the visual fields testing in accordance with the applicable LCD.
- Documentation should include relevant medical history, a physical examination, and results of pertinent diagnostic tests or procedures supporting the need for visual fields testing.
- The diagnosis code(s) reported on the claim must best describe the patient's condition for which the visual fields testing was performed.
- Refer to NCCI and OPPS requirements prior to billing Medicare to ensure coding compliance and to determine any bundling or packaging edits.
Key Coverage Criteria
- Billing and coding for Category III codes is allowed only when the service meets the coverage indications, limitations, and medical necessity criteria described in LCD L35490 and the performing physician (MD/DO) meets all criteria in that LCD and this Billing and Coding Article.
- CPT 0446T, 0447T, and 0448T (creation/removal/replacement of implantable interstitial glucose sensor) are billed and covered only per LCD L38686 and Billing and Coding Article A58213 when all criteria in that LCD/article are met.
- CPT 0421T and HCPCS C2596 (transurethral waterjet ablation of the prostate and associated probe) are billed and covered only per LCD L38682 and Billing and Coding Article A58209 when all criteria in that LCD/article are met.
- Electrocardiographic (EKG/ECG) monitoring (Holter or real-time) billing and coverage follow LCD L34636 and Billing and Coding Article A57476 and are allowed when those LCD/article criteria are met.
- Electrodiagnostic testing (EMG and/or nerve conduction studies) is indicated for evaluation of suspected carpal tunnel syndrome.
- EMG and/or nerve conduction studies are indicated for evaluation of suspected radiculopathy.
20 Active Policies
A57592 — Billing and Coding: Non-Invasive Cerebrovascular Studies
J05
A57478 — Billing and Coding: Nerve Conduction Studies and Electromyography
J05
L35753 — Non-Invasive Cerebrovascular Studies
J05
L39713 — Trigger Point Injections
J05
A56902
Related Codes
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