I82.521 — Chronic embolism and thrombosis of right iliac vein
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- 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.
Key Coverage Criteria
- 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.
- 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.
20 Active Policies
L35751 — Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
J05
L40273 — MolDX: Genetic Testing for Hereditary Thrombophilia
J05
A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
J05
L35755 — Non-Invasive Abdominal / Visceral Vascular Studies
J05
Related Codes
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