I82.5Z1 — Chronic embolism and thrombosis of unspecified deep veins of right distal lower extremity
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- 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.
Key Coverage Criteria
- 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 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.
20 Active Policies
L40273 — MolDX: Genetic Testing for Hereditary Thrombophilia
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A60307 — Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
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L35751 — Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
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A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
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Related Codes
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