Does I82.542 require prior authorization?

No, I82.542 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I82.542` — Chronic embolism and thrombosis of left tibial vein

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.
Coverage determinations for biomarker testing follow Local Coverage Determination L35062 and services are covered when reasonable and necessary per that LCD.
Serum homocysteine testing is covered for evaluation of suspected vitamin B12 (cobalamin) deficiency.
Serum homocysteine testing is covered for risk stratification for the conditions listed in the ICD-10-CM Codes that Support Medical Necessity in LCD L34419.
Serum homocysteine testing is covered for evaluation of suspected folate (vitamin B9) deficiency.

L35751 — Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

J05

A60307 — Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia

J05

L40273 — MolDX: Genetic Testing for Hereditary Thrombophilia

J05

A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

J05

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