I72.9 — Aneurysm of unspecified site
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Non-obstetric, gynecologic, duplex ultrasonography of the abdomen or pelvis, in the outpatient setting, is consideredmedically necessarywhen there is a documented health history and physical examination findings that indicate visualization of vascular characteristics is necessary, including but not limited to evaluation or suspicion of the following conditions:
- Abnormal uterine bleeding; or
- Endometrial polyps; or
- Endometriomas; or
- Neoplasm; or
- Ovarian or adnexal cysts; or
1 Active Policy
ANTHEM-CG-MED-84 — CG-MED-84 Non-Obstetric Gynecologic Duplex Ultrasonography of the Abdomen and Pelvis in the Outpatient Setting
Related Codes
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