R31.0 — Gross hematuria
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- 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 such as 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 selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Key Coverage Criteria
- Diagnostic abdominal aortography and renal angiography are covered when they meet the reasonable and necessary clinical requirements specified in LCD L35092.
- When femoral or iliac angiography is performed at the time of coronary angiography, bill using HCPCS code G0278.
- Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
- Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.
- Duplex scanning is covered only when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33674.
- Cystatin C measurement is covered when medical record documents an adult patient (>=18 years) with a creatinine-based eGFR of 45–59 ml/min/1.73 m2 and no markers of kidney damage.
20 Active Policies
A57636 — Billing and Coding: Duplex Scanning
J09
A57056 — Billing and Coding: Aortography and Peripheral Angiography
J09
L33674 — Duplex Scanning
J09
L36767 — Aortography and peripheral angiography
J09
L39367 — Genetic Testing in Oncology: Specific Tests
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.