Does I49.8 require prior authorization?

No, I49.8 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I49.8` — Other specified cardiac arrhythmias

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, be legible, include complete patient identification (e.g., full name, dates of service), and be made available to the contractor upon request.
Every submitted medical record page 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) and the submitted CPT/HCPCS code must accurately describe the service performed.
If the service provider differs from the ordering/referring physician, the performing provider must maintain hard copy documentation of test results and interpretation plus copies of the ordering/referring physician’s order for the studies.

Coverage for non-emergent outpatient stress testing is subject to the reasonable and necessary requirements in Local Coverage Determination L35083 and is allowed only when L35083 clinical criteria are met.
When billing Medicare Part B for analysis of a Wearable Defibrillator System, report CPT code 93292.
Report CPT codes 93260, 93261, and 93279-93292 when performing the corresponding cardiac rhythm device evaluation procedures (reported per procedure).
Coverage and billing for cardiac event detection should follow the clinical indications and medical necessity criteria specified in Local Coverage Determination L34573.
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).

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

J05

L34636 — Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)

J05

A56781 — Billing and Coding: Transthoracic Echocardiography (TTE)

J06

L33577 — Transthoracic Echocardiography (TTE)

J06

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