O16.1 — Unspecified maternal hypertension, first trimester
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Evaluation of germ cell tumors;or
- Testicular cancer or suspicious testicular mass;or
- Ovarian cancer;or
- Pelvic mass;or
- Mediastinal mass;or
- Retroperitoneal mass;or
2 Active Policies
ANTHEM-CG-LAB-27 — CG-LAB-27 Human Chorionic Gonadotropin Testing
ANTHEM-CG-RAD-26 — CG-RAD-26 Maternity Ultrasound in the Outpatient Setting
Related Codes
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