I82.0 — Budd-Chiari syndrome
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Claims must be submitted with an ICD-10-CM code that represents the reason for the procedure, billed to the highest level of specificity and linked to the appropriate procedure code.
- All documentation must be maintained in the patient's medical record, be legible, include patient identification and dates of service, and include the legible signature of the responsible physician or non-physician practitioner.
- 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.
- Medical record documentation should list the type and length of conservative treatment attempted, as applicable per LCD L37893.
Key Coverage Criteria
- Endovenous stenting is covered when performed to treat severely symptomatic venous obstructions in accordance with LCD L37893.
- Coverage determinations for biomarker testing follow Local Coverage Determination L35062 and services are covered when reasonable and necessary per that LCD.
- Endovenous stenting is covered when used to treat severely symptomatic venous obstructions in accordance with LCD L38231.
- Non-invasive vascular studies (duplex scan, physiologic studies, plethysmography, transcranial Doppler) are covered when ordered by the treating or consulting practitioner and medically necessary to evaluate, diagnose, or manage vascular disease.
- Initial autogenous access vessel mapping should be billed with HCPCS codes 93985 or 93986 and is covered when medically necessary for surgical planning.
- Subsequent autogenous access mapping may be billed with CPT codes 93970 or 93971 when clinically indicated.
20 Active Policies
A60307 — Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
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A57591 — Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies
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L35755 — Non-Invasive Abdominal / Visceral Vascular Studies
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L40273 — MolDX: Genetic Testing for Hereditary Thrombophilia
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Related Codes
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