Does G90.09 require prior authorization?

No, G90.09 does not require prior authorization (high confidence). Code is covered without prior authorization.

`G90.09` — Other idiopathic peripheral autonomic neuropathy

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Autonomic function tests are covered when they meet the reasonable and necessary requirements of Local Coverage Determination (LCD) L35395.
Cardiovagal innervation testing should be reported when performed using CPT code 95921.
Vasomotor adrenergic innervation testing should be reported when performed using CPT code 95922.
Sudomotor (sweat) function testing should be reported when performed using CPT code 95923, provided the testing meets the CPT-defined subject preparation, environmental, and personnel requirements.
Combined parasympathetic and sympathetic adrenergic function testing should be reported when performed using CPT code 95924.

A57478 — Billing and Coding: Nerve Conduction Studies and Electromyography

J05

A57551 — Billing and Coding: Autonomic Function Testing

J05

L35124 — Autonomic Function Testing

J05

L34594 — Nerve Conduction Studies and Electromyography

J05

A57668

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