Does L83 require prior authorization?

No, L83 does not require prior authorization (high confidence). Code is covered without prior authorization.

`L83`, Acanthosis nigricans

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Legible medical records must reference the patient's complaint or the physician's physical findings when billing with diagnosis L82.0.
Documentation must support a significant, separately identifiable E/M service when modifier 25 is appended (separate E/M note tied to the visit and not just the procedure).
Verify applicable procedure and global policy coding via the Medicare Physician Fee Schedule Database (MPFSDB) to determine where the global surgical policy applies.
The medical record must document the medical reasonableness, necessity, and clinical frequency of the diagnostic colonoscopy or sigmoidoscopy and be available to the Contractor upon request.

Removal of benign or malignant skin lesions is addressed per the Local Coverage Determination L33445 and related billing/coding guidance.
Diagnosis code L82.0 (inflamed seborrheic keratosis) may be used when the medical record documents the patient's complaint or the physician's physical findings for the lesion.
Diagnostic colonoscopy or sigmoidoscopy is covered to directly visualize the lower gastrointestinal tract (colon, rectum, sigmoid) to detect polyps, tumors, or other intestinal lesions.
Diagnostic colonoscopy is covered when identification of the site of pathology and/or obtaining a biopsy during the procedure is clinically indicated.
A follow-on screening colonoscopy is covered after a positive covered blood-based biomarker noninvasive colorectal cancer (CRC) screening test per NCD 210.3, effective 2025-01-01.
A colonoscopy may be billed when a sigmoidoscope is used only if the bowel is sufficiently short that the entire colon can be examined and this fact is clearly documented in the clinical record.

A56394, Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic

WPS-L34614, Colonoscopy and Sigmoidoscopy-Diagnostic

A56346, Billing and Coding: Removal of Benign and Malignant Skin Lesions

A57342, Billing and Coding: Diagnostic and Therapeutic Colonoscopy

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