Does I77.1 require prior authorization?

No, I77.1 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I77.1` — Stricture of artery

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

When billing these procedures after carotid endarterectomy, include the surgery date and the phrase 'carotid endarterectomy' in the claim narrative.
When reporting a reduced (unilateral/limited) service, append modifier -52 and include an explanation of the reduced service in Item 19 of the CMS-1500 form or electronic equivalent; any appropriate supporting documentation may be submitted with the claim.
Follow Novitas LCD L35397 for the reasonable and necessary documentation requirements and frequency limitations, and consult NCCI edits for correct coding combinations prior to billing Medicare.
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.

Non-invasive cerebrovascular arterial studies are covered when reasonable and necessary as defined by Novitas Local Coverage Determination (LCD) L35397.
Duplex post-interventional follow-up studies (typically limited and unilateral) are covered for evaluation after cerebrovascular intervention.
Vascular studies performed after carotid endarterectomy are covered when the claim includes the procedure date and the narrative 'carotid endarterectomy.'
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 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.
Diagnostic abdominal aortography and renal angiography are covered when they meet the reasonable and necessary clinical requirements specified in LCD L35092.

L35761 — Non-Invasive Peripheral Arterial Vascular Studies

J05

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

J05

L33627 — Non-Invasive Vascular Studies

J06

L33633 — Magnetic Resonance Angiography (MRA)

J06

A56747

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