O30.93 — Multiple gestation, unspecified, third trimester
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
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.
4 Active Policies
ANTHEM-RAD.00038 — RAD.00038 Use of 3-D, 4-D or 5-D Ultrasound in Maternity Care
ANTHEM-CG-LAB-24 — CG-LAB-24 Outpatient Urine Culture
ANTHEM-CG-LAB-25 — CG-LAB-25 Outpatient Glycated Hemoglobin and Protein Testing
ANTHEM-CG-RAD-26 — CG-RAD-26 Maternity Ultrasound in the Outpatient Setting
Related Codes
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