Does I70.298 require prior authorization?

No, I70.298 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I70.298` — Other atherosclerosis of native arteries of extremities, other extremity

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
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.
CPT 78434 (gated SPECT) may be reported only in conjunction with CPT 78431 or CPT 78492 when billed for SPECT myocardial perfusion imaging (MPI).
SPECT MPI includes routine evaluation of left ventricular wall motion and left ventricular ejection fraction (LVEF) as part of the MP1 service definition.
Non-invasive peripheral arterial vascular studies are covered when the study results will be used in the clinical management of the patient and the medical necessity is documented in the medical record.
One preoperative non-invasive vascular scan for bypass surgery is reasonable and covered to guide surgical planning.

A57593 — Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies

J05

L35761 — Non-Invasive Peripheral Arterial Vascular Studies

J05

L36523 — MolDX: Biomarkers in Cardiovascular Risk Assessment

J05

A57559 — Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

J05

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