Does O15.1 require prior authorization?

No, O15.1 does not require prior authorization (high confidence). Code is covered without prior authorization.

`O15.1` — Eclampsia complicating labor

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

A57327 — Billing and Coding: Electrocardiograms

A57189 — Billing and Coding: Serum Magnesium

A57326 — Billing and Coding: Electrocardiograms

L34315 — Electrocardiograms

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