N99.840 — Postprocedural hematoma of a genitourinary system organ or structure following a genitourinary system procedure
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
- This billing and coding guideline complements Local Coverage Determination (LCD) L34424 for Magnetic Resonance Angiography; refer to LCD L34424 for clinical indications, medical necessity criteria, and specific coding rules.
- CT scans must be performed on CT equipment models that are FDA-known and in full market release phase.
- Medical records must document that MRA is reasonable and necessary for the patient's diagnosis or treatment and, where claimed, that it replaces a more invasive test and reduces risk; coverage follows CMS NCD Pub. 100-03, Ch.1, Pt.4, §220.2.
Key Coverage Criteria
- CT abdomen is medically necessary to evaluate abdominal pain.
- CT abdomen is medically necessary to evaluate known or suspected abdominal masses or fluid collections.
- CT abdomen is medically necessary for evaluation of primary or metastatic malignancies in the abdomen.
- CT abdomen is medically necessary to evaluate abdominal inflammatory processes.
- CT abdomen is medically necessary to evaluate abnormalities of abdominal vascular structures.
- CT abdomen is medically necessary to evaluate abdominal trauma.
5 Active Policies
A59845 — Billing and Coding: Magnetic Resonance Angiography
A56421 — Billing and Coding: CT of the Abdomen and Pelvis
A56775 — Billing and Coding: Magnetic Resonance Angiography
L34415 — CT of the Abdomen and Pelvis
L34424 — Magnetic Resonance Angiography
Related Codes
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