Does H59.342 require prior authorization?

No, H59.342 does not require prior authorization (high confidence). Code is covered without prior authorization.

`H59.342` — Postprocedural hematoma of left eye and adnexa following other procedure

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
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.
This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.
Medical record documentation must demonstrate clinical evidence of an intracranial disorder or documentation of an established intracranial disease to support coverage of cranial CT.

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.
Cranial CT (with or without contrast) is covered when the patient has clinical evidence of an intracranial disorder or an established intracranial disorder/disease.
Contrast-enhanced CT is reasonable and necessary to assess cerebral perfusion, for example in suspected or known cerebrovascular accident (CVA).
Contrast-enhanced CT is covered to characterize a specific intracranial lesion.
Contrast-enhanced CT is covered to detect blood–brain barrier defects such as infarcts, tumors, infection, or vasculitis.
Contrast-enhanced CT is covered to detect neovascularity associated with intracranial tumors.

A59840 — Billing and Coding: Magnetic Resonance Imaging of the Head and Neck

A59845 — Billing and Coding: Magnetic Resonance Angiography

A56612 — Billing and Coding: CT of the Head

A56729 — Billing and Coding: Magnetic Resonance Imaging of the Head and Neck

A56775 — Billing and Coding: Magnetic Resonance Angiography

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