Does Q85.02 require prior authorization?

No, Q85.02 does not require prior authorization (high confidence). Code is covered without prior authorization.

`Q85.02` — Neurofibromatosis, type 2

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the patient's medical record and made available to the contractor upon request; every page must be legible and include patient identification and dates of service.
The medical record must include the legible signature of the physician or non-physician practitioner responsible for and providing care to the patient.
The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
For services requiring a referring/ordering physician, the claim must report the referring/ordering physician's name and NPI.

Continuous intraoperative neurophysiologic monitoring provided one-on-one in the operating room (CPT 95940) is covered when it supports the covered indications in LCD L35003.
Report continuous intraoperative neurophysiologic monitoring in the operating room (95940) in addition to monitoring services provided from outside the operating room (G0453); coverage includes interpretation of baseline studies and removal of electrodes at the end of the procedure when supporting the LCD indications.
Reimbursement may be made for covered intraoperative monitoring when performed at POS 19, POS 21, POS 22, or POS 24.
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.

A57604 — Billing and Coding: Intraoperative Neurophysiological Testing

J05

A57597 — Billing and Coding: Somatosensory Testing

J05

L34615 — Visual Fields

J05

L34624 — Somatosensory Testing

J05

L34623 — Intraoperative Neurophysiological Testing

Ask Verity about documentation requirements, denial risks, or coverage in your state.