Does R25.9 require prior authorization?

No, R25.9 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R25.9` — Unspecified abnormal involuntary movements

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medical records must be maintained and available upon request; every page must be legible and include patient identification (e.g., full name, dates of service) and identify the physician or non-physician practitioner responsible for care.
Submitted medical records must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Claims and documentation requirements for CPNB are governed by and must follow the Local Coverage Determination L37641 referenced by this guideline.
This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.

Regional or local nerve blocks performed as an adjunct to, or as the sole means of, regional/local anesthesia for an operative procedure are not affected by this noncoverage policy (i.e., such intraoperative regional/local anesthesia is allowed).
No specific coverage indications are stated in this billing/coding guideline; refer to Local Coverage Determination L37641 for covered indications for continuous peripheral nerve blocks (CPNB).
Ambulatory continuous EEG is covered only if a prior routine “resting” EEG was performed before the ambulatory EEG.
Routine EEGs covered under this policy are those described by CPT codes 95812, 95813, 95816, 95819, or 95822.
A routine EEG is defined as a recording of less than a 24-hour continuous duration.
Neurophysiology Evoked Potentials (NEPs) — including Somatosensory Evoked Potentials (SEPs), Brainstem Auditory Evoked Potentials (BAEPs/BAERs), and Visual Evoked Potentials (VEPs/VERs) — are covered when determined to be reasonable and necessary in accordance with LCD L34975.

A57030 — Billing and Coding: EEG Ambulatory Monitoring

J06

L33399 — EEG Ambulatory Monitoring

J06

A57668 — Billing and Coding: Nerve Conduction Studies and Electromyography

J06

L35098 — Nerve Conduction Studies and Electromyography

J06

A57122

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