Does I27.849 require prior authorization?

No, I27.849 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I27.849` — Fontan related circulation, unspecified

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
When a limited or follow-up echocardiogram is performed, document the targeted cardiac problem/region and bill using the appropriate CPT code (93308 or 93321).
If the study is a screening exam, document and bill with the appropriate screening ICD-10 code; document any abnormal findings and use the resulting diagnosis for subsequent billing when applicable.
Document use of ultrasound contrast enhancement and its supplies separately when billed, and do not submit separate claims for diagnostic injection services integral to the contrast procedure.

Follow-up or limited transthoracic echocardiography performed to evaluate a single specified cardiac problem or region must be billed with CPT 93308.
Limited Doppler/follow-up echocardiographic studies (for targeted velocity or gradient assessment) should be billed with CPT 93321 (e.g., tricuspid regurgitant velocity to estimate pulmonary artery systolic pressure or sequential transmitral velocity in mitral stenosis).
Coverage and clinical indications for Cardiac Computed Tomography & Angiography (CCTA) follow the Local Coverage Determination LCD L33423; this billing article provides complementary coding guidance only.
Therapeutic procedures whose principal aim is to treat a respiratory impairment must be billed using HCPCS codes G0237, G0238, or G0239.
CPT 94762 is medically necessary when intermittent arterial blood gas sampling is likely to miss important variations in the patient's respiratory status.
CPT 94762 is medically necessary when the patient has hypoxemia and there is a need to assess supplemental oxygen requirements and/or a therapeutic oxygen regimen.

A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

J05

L35751 — Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

J05

L35755 — Non-Invasive Abdominal / Visceral Vascular Studies

J05

A57591 — Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

J05

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