Does H53.021 require prior authorization?

No, H53.021 does not require prior authorization (high confidence). Code is covered without prior authorization.

`H53.021` — Refractive amblyopia, right eye

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
For congenital anomalies, use CPT code 93315 (HCPCS C8926 for OPPS billing) for the complete contrast TEE procedure.
Hospitals should bill echocardiograms without contrast using the applicable Level 1 CPT code descriptors and guidelines.
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.
Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and necessary.

A57483 — Billing and Coding: Visual Fields

J05

L37015 — Visual Electrophysiology Testing

J05

L34615 — Visual Fields

J05

A57599 — Billing and Coding: Visual Electrophysiology Testing

J05

A57060 — Billing and Coding: Visual Electrophysiology Testing

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