Does R35.89 require prior authorization?

No, R35.89 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R35.89` — Other polyuria

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

There must be an attending/treating physician's order for each test documented in the patient's medical/clinical record prior to performing CPT 51798.
The patient's medical record must include the assessment related to the visit complaint, relevant medical history, physical examination, results of pertinent tests/procedures, plan of treatment, and signed and dated office visit or operative report.
Results documentation must show that the measurement was performed immediately post-void, include the date of the test, and identify the person who performed the test.
For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.

Measurement of post-void residual urine and/or bladder capacity by ultrasound (CPT 51798) is covered when ordered by the attending/treating/referring physician to evaluate a patient's urinary complaint and the medical record documents medical necessity (relevant history, physical exam, and supporting diagnostic results).
Parathormone (parathyroid hormone) testing is covered when medical necessity and reasonable-and-necessary criteria specified in Local Coverage Determination L34018 are met.
For renal dialysis facilities submitting claims for parathormone testing, use diagnosis code N18.6 (end stage renal disease).
PTH testing is covered for evaluation of patients with a prior diagnosis of hyperparathyroidism or hypoparathyroidism.
PTH testing is covered to evaluate a patient with an abnormal total serum calcium level.
PTH testing is covered to distinguish parathyroid from non-parathyroid causes of hypercalcemia.

L34018 — Parathormone (Parathyroid Hormone)

J09

A57122 — Billing and Coding: Parathormone (Parathyroid Hormone)

J09

ANTHEM-CG-LAB-28 — CG-LAB-28 Prostate Specific Antigen Testing

ANTHEM-CG-LAB-30 — CG-LAB-30 Outpatient Laboratory-based Blood Glucose Testing

ANTHEM-CG-LAB-32 — CG-LAB-32 Cancer Antigen 125 Testing

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