Does I25.702 require prior authorization?

No, I25.702 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I25.702` — Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Claims for stress tests performed as preoperative evaluation of asymptomatic, moderate-risk patients must include medical record documentation of at least one of: diabetes mellitus with complications; peripheral vascular disease; aortic aneurysm; or cerebrovascular disease.
The patient's medical record must include the ordering provider's assessment related to the patient's complaint for that visit.
The medical record must include relevant medical history and results of pertinent tests and procedures.
Office visit records and operative reports must be signed and dated; all services ordered or rendered to Medicare beneficiaries must be signed.

Preoperative cardiac stress testing with radionuclide imaging for asymptomatic patients deemed at moderate risk is covered only if the medical record documents at least one of the following: diabetes mellitus with complications; peripheral vascular disease; aortic aneurysm; or cerebrovascular disease.
For services that require a referring or ordering physician, the claim must report the referring/ordering physician's name and NPI.
Claims must include a valid ICD-10-CM diagnosis code that best describes the patient's condition for which the service was performed; otherwise the claim will be returned as incomplete under SSA Section 1833(e).
For diagnostic tests, the claim should report the test result if known, otherwise report the symptoms that prompted the test.
If a service is likely to be non-covered, an Advance Beneficiary Notice (ABN) may be used and the appropriate modifier (GA, GX, GY, or GZ) should be appended to the claim as applicable.
Follow-up or limited transthoracic echocardiography performed to evaluate a single specified cardiac problem or region must be billed with CPT 93308.

A57476 — Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)

J05

A57552 — Billing and Coding: Coronary Computed Tomography Angiography (CCTA)

J05

L34761 — Percutaneous Coronary Interventions

J05

L35761 — Non-Invasive Peripheral Arterial Vascular Studies

J05

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