Does H18.11 require prior authorization?

No, H18.11 does not require prior authorization (high confidence). Code is covered without prior authorization.

`H18.11` — Bullous keratopathy, right eye

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The medical record must include the ordering provider's assessment relevant to the patient's complaint for that visit.
The medical record must include relevant medical history related to the service.
The medical record must include results of pertinent tests and procedures; for diagnostic tests report the actual test result if known, otherwise report the symptoms prompting the test.
All office visit records and operative reports must be signed and dated; all services ordered or rendered to Medicare beneficiaries must be signed.

Scanning computerized ophthalmic diagnostic imaging (SCODI) is covered when the service meets the medical necessity criteria and is included within Local Coverage Determination L34380.
Corneal pachymetry (measurement of corneal thickness) is covered to evaluate patients with a diagnosis of increased intraocular pressure.
Repeat corneal pachymetry is covered after interval corneal trauma or corneal surgery to reassess corneal thickness.
Corneal pachymetry is generally covered when performed as indicated by current medical literature or accepted standards of practice for clinical management.
Computerized corneal topography is billable when performed as a diagnostic test for corneal conditions and the claim includes a diagnosis code that best describes the patient's condition for which the service was performed.
When distinct clinical circumstances require both SCODI (CPT 92133 or 92134) and fundus photography (CPT 92250) to evaluate or treat the patient, both procedures may be reported together with modifier 59 to indicate a distinct procedural service.

L34615 — Visual Fields

J05

L34760 — Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

J05

A57483 — Billing and Coding: Visual Fields

J05

A56916 — Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

J05

A56537

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