O26.649 — Intrahepatic cholestasis of pregnancy, unspecified trimester
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Exposure to hepatotoxins;or
- Gastrointestinal disease;or
- Liver transplantation;or
- Primary or secondary malignant neoplasms;or
- Infections that may cause liver injury (for example, viral hepatitis, amoebiasis, tuberculosis, and similar infections);or
- Pancreatic disease;or
1 Active Policy
ANTHEM-CG-LAB-29 — CG-LAB-29 Gamma Glutamyl Transferase Testing
Related Codes
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