P78.84 — Gestational alloimmune liver disease
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Pregnant and considered to be at high risk for type 2 diabetes mellitus;or
- Impaired fasting glucose has been found on other testing;or
- Blood glucose testing is consideredmedically necessaryfor individuals who meet any of the following criteria (A through Q):
- Signs or symptoms of either of the following:Hypoglycemia;orHyperglycemia;or
- Hypoglycemia;or
- Hyperglycemia;or
1 Active Policy
ANTHEM-CG-LAB-30 — CG-LAB-30 Outpatient Laboratory-based Blood Glucose Testing
Related Codes
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