H57.8A3 — Foreign body sensation, bilateral eyes
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Full policy text not provided; required documentation (medical records, prior authorization, forms) cannot be extracted from the supplied content.
- Billing and coding guidance in this policy complements and references Local Coverage Determination L34425; claims should be supported per the documentation requirements specified in LCD L34425.
- List the appropriate CPT code for the procedure and include any applicable modifiers; adhere to Medicare global surgery and CCI (correct coding initiative) rules for eyelid surgeries.
- Submit physicians' services and diagnostic tests with a diagnosis code that supports medical necessity and code to the greatest level of specificity (full digit completeness).
Key Coverage Criteria
- Full policy text not provided; specific clinical indications for blepharoplasty, eyelid surgery, and brow lift cannot be extracted from the supplied content.
- No specific clinical indications are listed in this billing/coding guidance; coverage determinations for MRI of the head and neck follow Local Coverage Determination L34425.
- Blepharoplasty, blepharoptosis repair, or brow lift is covered when documented signs or symptoms of a functional abnormality of the upper eyelids are present as defined by the associated LCD (L34528).
- Taped and un-taped visual field testing count as one unit of service for MUE (medically unlikely edits) purposes.
- Global visual field services (technical plus professional) are payable under Medicare Part B when billed in place of service: Office (11), Nursing Facility (32), and Independent Clinic (49).
- The technical component of visual field testing is payable under Medicare Part B when billed in place of service: Office (11), Nursing Facility (32), Independent Clinic (49), Federally Qualified Health Center (50), and Rural Health Clinic (72).
9 Active Policies
L34615 — Visual Fields
J05
A56908 — Billing and Coding: Blepharoplasty, Blepharoptosis and Brow Lift
J05
A57483 — Billing and Coding: Visual Fields
J05
L34528 — Blepharoplasty, Blepharoptosis and Brow Lift
J05
A59840 — Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Related Codes
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