Does I80.8 require prior authorization?

No, I80.8 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I80.8` — Phlebitis and thrombophlebitis of other sites

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

The final report must include an impression or summary statement, a specific or differential diagnosis if appropriate, and recommendations for follow-up when clinically applicable.
All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and be available to the contractor upon request.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing care.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

Doppler ultrasound (peripheral venous ultrasound) is the standard preoperative test to evaluate venous reflux in patients with chronic venous insufficiency.
CPT 93971 should be used to report either a limited bilateral duplex scan or a complete unilateral duplex scan for peripheral venous reflux evaluation.
Diagnostic mammography, breast sonography (echography), breast MRI, and ductography are covered when a clear clinical indication for the test is documented in the medical record and in the referral/order.
A diagnostic mammogram performed after an initial screening mammogram (conversion from screening to diagnostic) is allowable when the screening abnormality prompting additional views is documented in the record.
Claims for dialysis access maintenance billed to Medicare Part A or Part B should be submitted when coding conforms to the applicable Local Coverage Determination L34062 and applicable NCCI and OPPS coding/packaging edits.
For services that require a referring or ordering physician, claims must include the referring/ordering physician's name and NPI to be eligible for payment.

L35755 — Non-Invasive Abdominal / Visceral Vascular Studies

J05

L35998 — Non-Coronary Vascular Stents

J05

A57590 — Billing and Coding: Non-Coronary Vascular Stents

J05

A57591 — Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

J05

A57594

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