Does I68.2 require prior authorization?

No, I68.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I68.2` — Cerebral arteritis in other diseases classified elsewhere

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The patient's medical record must contain documentation that fully supports the medical necessity for the visual fields testing in accordance with the applicable LCD.
Documentation should include relevant medical history, a physical examination, and results of pertinent diagnostic tests or procedures supporting the need for visual fields testing.
The diagnosis code(s) reported on the claim must best describe the patient's condition for which the visual fields testing was performed.
Refer to NCCI and OPPS requirements prior to billing Medicare to ensure coding compliance and to determine any bundling or packaging edits.

Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and necessary.
For diagnostic visual field tests, report the test result on the claim if known; if the result is not known, report the signs or symptoms that prompted the test.
If the service requires a referring/ordering physician, include the ordering/referring physician’s name and NPI on the claim.
Magnetic resonance angiography (MRA) is covered only when the service meets the reasonable and necessary coverage criteria specified in Local Coverage Determination L34865.
Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.

A57592 — Billing and Coding: Non-Invasive Cerebrovascular Studies

J05

L35753 — Non-Invasive Cerebrovascular Studies

J05

L33574 — Visual Fields Testing

J06

A56551 — Billing and Coding: Visual Fields Testing

J06

A57056 — Billing and Coding: Aortography and Peripheral Angiography

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