I70.308 — Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, other extremity
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.
- Claims should be supported with documentation consistent with LCD L36129; this article provides billing and coding guidelines that complement that LCD and should be used alongside the LCD when submitting claims.
- Billing, coding, and guideline information herein complement and must be used in conjunction with the Local Coverage Determination MolDX: Biomarkers in Cardiovascular Risk Assessment (LCD L36358); follow LCD L36358 for clinical criteria and claim adjudication.
- Required documentation and claim substantiation should follow the documentation requirements and MolDX program instructions in LCD L36362; no additional specific forms or certifications are specified in this article.
Key Coverage Criteria
- No clinical indications are specified in this article; coverage indications are determined by the referenced LCD L36362 (MolDX: Biomarkers in Cardiovascular Risk Assessment).
- This article contains billing and coding guidance only and does not itself define clinical indications; refer to MolDX: Biomarkers in Cardiovascular Risk Assessment LCD L36139 for covered clinical indications.
- 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.
- Immediate postoperative studies are covered when re-established pulses are lost or become equivocal, or the patient develops signs or symptoms of ischemia suggesting impending repeat intervention.
- Medically necessary follow-up noninvasive studies after angioplasty are covered, with the follow-up frequency determined by the vascular distribution treated and documented medical necessity.
20 Active Policies
A57593 — Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies
J05
L35761 — Non-Invasive Peripheral Arterial Vascular Studies
J05
A57559 — Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
J05
L36523 — MolDX: Biomarkers in Cardiovascular Risk Assessment
J05
Related Codes
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