O23.00 — Infections of kidney in pregnancy, unspecified trimester
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Record of specimen type as fresh vaginal discharge.
- Documented pH value (numeric) when pH testing performed.
- Microscopy findings from both saline and KOH preparations, including presence/absence of motile T. vaginalis, clue cells, yeast, and white blood cells.
- Result of whiff/amine test when performed.
Key Coverage Criteria
- Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:
- Clinical signs or symptoms suggesting urinary tract infection (UTI);or
- Abnormal urinalysis suggesting UTI;or
- Asymptomatic bacteriuria in pregnant persons;or
- Bacteriuria in individuals prior to undergoing an endoscopic urologic procedure;or
- Suspected interstitial cystitis or bladder pain syndrome.
3 Active Policies
AMBETTER-CP.MP.97 — Testing for Select Genitourinary Conditions
AMBETTER-CP.MP.38 — Ultrasound in Pregnancy
ANTHEM-CG-LAB-24 — CG-LAB-24 Outpatient Urine Culture
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.