I82.211 — Chronic embolism and thrombosis of superior vena cava
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 abdominal/visceral vascular studies are covered when the test results will be used to directly inform or change the patient's clinical management.
- A preoperative non‑invasive abdominal/visceral vascular study is covered as reasonable and necessary for patients undergoing bypass surgery (one preoperative scan considered reasonable).
- Medically necessary follow‑up non‑invasive abdominal/visceral vascular studies after angioplasty are covered as indicated by the vascular distribution treated.
14 Active Policies
A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
J05
L35755 — Non-Invasive Abdominal / Visceral Vascular Studies
J05
L35751 — Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
J05
A57591 — Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies
J05
Related Codes
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