Does R06.89 require prior authorization?

No, R06.89 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R06.89` — Other abnormalities of breathing

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 of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
For congenital anomalies, use CPT code 93315 (HCPCS C8926 for OPPS billing) for the complete contrast TEE procedure.
Hospitals should bill echocardiograms without contrast using the applicable Level 1 CPT code descriptors and guidelines.
Cardiovascular nuclear medicine testing is reimbursable for risk assessment or re-evaluation in asymptomatic patients or patients with stable symptoms who have known atherosclerotic heart disease on catheterization or SPECT perfusion imaging, provided the patient has not undergone a revascularization procedure within the prior 2 years.
Blood pool scan to assess left ventricular ejection fraction prior to implantation of an implantable cardioverter-defibrillator (ICD) or biventricular pacemaker is covered when the medical record documents the intended plan for device insertion and the test result.

A57473 — Billing and Coding: Allergy Testing

J05

L36402 — Allergy Testing

J05

A57476 — Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)

J05

L34636 — Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)

J05

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