N17.8 — Other acute kidney failure
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- Required documentation, prior authorization requirements, and coding instructions for hospice renal care follow the LCD L34559 and local Medicare contractor policies; retain medical records supporting hospice eligibility and renal diagnosis as specified by the LCD.
- The ordering/referring practitioner's assessment related to the patient's complaint and the specific reason for the test must be documented in the medical record.
- The medical record must contain a referral/order on file for each non‑invasive vascular study performed.
- Results of pertinent tests and procedures performed that relate to the indication must be included in the medical record and reported on the claim if known; otherwise report the symptoms that prompted the test.
Key Coverage Criteria
- Coverage for hospice renal care is determined by the Local Coverage Determination (LCD) L34559; refer to LCD L34559 for specific covered diagnoses and clinical criteria for hospice renal services.
- 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.
- Cerebrovascular arterial duplex follow-up is covered annually for stenosis 20–49% (diameter reduction).
- Cerebrovascular arterial duplex follow-up is covered every six months for stenosis 50–79% (diameter reduction).
- Cerebrovascular arterial duplex follow-up is covered every six months for stenosis 80–99% if surgical correction has not been performed.
20 Active Policies
A60273 — Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection
J05
L35998 — Non-Coronary Vascular Stents
J05
L35755 — Non-Invasive Abdominal / Visceral Vascular Studies
J05
L40248 — MolDX: Molecular Testing for Solid Organ Allograft Rejection
J05
Related Codes
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