Does O04.85 require prior authorization?

No, O04.85 does not require prior authorization (high confidence). Code is covered without prior authorization.

`O04.85` — Other venous complications following (induced) termination of pregnancy

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medical records must document the medical necessity of the serum magnesium test, including the signs, symptoms, and/or diagnosis that prompted the test.
Laboratories must maintain the physician's order for the serum magnesium test in their records.
Medical records must contain the serum magnesium lab test results.
When requesting individual consideration through written redetermination, providers must include all relevant medical records and supporting literature.

ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D56.1 - Beta thalassemia
ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.02 - Hb-SS disease with splenic sequestration
ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.1 - Sickle-cell disease without crisis
ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.212 - Sickle-cell/Hb-C disease with splenic sequestration
ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.412 - Sickle-cell thalassemia, unspecified, with splenic sequestration
ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.812 - Other sickle-cell disorders with splenic sequestration

A57198 — Billing and Coding: Serum Magnesium

A57189 — Billing and Coding: Serum Magnesium

L36700 — Serum Magnesium

L36702 — Serum Magnesium

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