Does I82.5Y1 require prior authorization?

No, I82.5Y1 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I82.5Y1` — Chronic embolism and thrombosis of unspecified deep veins of right proximal lower extremity

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification information such as complete name and dates of service.
The record must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.
The submitted medical record must support the use of the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

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.
Non-invasive vascular diagnostic tests are covered when ordered by the treating practitioner or a consulting physician who will use the results to manage the beneficiary's specific medical problem.
A documented referral/order must be on record for each individual non-invasive vascular study performed for coverage to apply.

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

J05

L40273 — MolDX: Genetic Testing for Hereditary Thrombophilia

J05

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

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.