Does I87.2 require prior authorization?

No, I87.2 does not require prior authorization (high confidence). Code is covered without prior authorization.

`I87.2` — Venous insufficiency (chronic) (peripheral)

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.
Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
Injection sclerotherapy (CPT 36468) is appropriate for treatment of symptomatic spider veins / telangiectasia of the lower extremities.
Non-compounded foam (NCF) sclerotherapy is appropriate for treatment of incompetent extremity truncal veins (report with CPT 36465 or 36466).
NCF sclerotherapy for other incompetent extremity veins is reported with CPT 36470 or 36471.

L37228 — Wound Care

J05

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

J05

A55909 — Billing and Coding: Wound Care

J05

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

J05

A56758

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