N02.B9 — Other recurrent and persistent immunoglobulin A nephropathy
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- The article provides billing/coding guidance that complements LCD L39400; use the documentation, prior authorization, and claim submission requirements specified in LCD L39400 and the local contractor's instructions.
Key Coverage Criteria
- No specific clinical indications are listed in this article; follow the Local Coverage Determination (LCD) L39400 for indications for magnesium testing or services.
- Serum magnesium testing is covered when hypomagnesemia is suspected due to gastrointestinal or renal losses or when patients present with symptoms of low magnesium (weakness, muscle cramps, confusion, irregular heartbeat, or seizures).
- Serum magnesium testing is covered for patients with conditions known to cause hypomagnesemia (examples include cardiac arrhythmias, proton pump inhibitor use, chronic alcohol use, uncontrolled diabetes mellitus, hypercalcemia, post–organ transplant status, inherited renal magnesium wasting, malabsorption syndromes, aminoglycoside or amphotericin B nephrotoxicity, cisplatin, pentamidine, calcineurin inhibitor therapy, digoxin use, prolonged IV or nasogastric therapy, parenteral alimentation with [...]
- Serum magnesium testing is covered when hypermagnesemia is suspected in patients with impaired renal function or after a large magnesium load (IV, oral, or enema) or when symptoms of high magnesium (muscle weakness, fatigue, nausea/vomiting, respiratory difficulty, or cardiac arrest) are present.
- Serum magnesium testing is covered for conditions associated with hypermagnesemia such as familial hypocalciuric hypercalcemia, hypercatabolic states (e.g., tumor lysis syndrome), diabetic ketoacidosis, lithium ingestion, milk-alkali syndrome, adrenal insufficiency, and rhabdomyolysis.
- Tonsillectomy is consideredmedically necessaryfor individuals 18 years of age and older who meet one or more of the criteria below:
5 Active Policies
ANTHEM-CG-SURG-113 — CG-SURG-113 Tonsillectomy with or without Adenoidectomy for Adults
ANTHEM-CG-LAB-21 — CG-LAB-21 Serum Iron Testing
ANTHEM-CG-SURG-51 — CG-SURG-51 Outpatient Cystourethroscopy
A59186 — Billing and Coding: Magnesium
L39400 — Magnesium
Related Codes
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