O36.8399 — Maternal care for abnormalities of the fetal heart rate or rhythm, unspecified trimester, other fetus
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high 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.
2 Active Policies
ANTHEM-CG-LAB-24 — CG-LAB-24 Outpatient Urine Culture
ANTHEM-CG-RAD-26 — CG-RAD-26 Maternity Ultrasound in the Outpatient Setting
Related Codes
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