Does R40.2123 require prior authorization?

No, R40.2123 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R40.2123` — Coma scale, eyes open, to pain, at hospital admission

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

For services requiring a referring or ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.
A claim submitted without a valid ICD-10-CM diagnosis code will be returned as an incomplete claim under Section 1833(e) of the Social Security Act.
The ICD-10-CM diagnosis code(s) reported must best describe the patient's condition for which the urine drug test was performed.
For diagnostic urine drug tests, report the test result if known; if the result is not known at claim time, report the symptoms that prompted performance of the test.

Urine drug testing (UDT) and drugs-of-abuse testing are covered when reasonable and necessary per LCD L35006 and ordered on an individual patient basis by the treating clinician with medical-record documentation of medical necessity.
Patients with a documented diagnosis consistent with substance use disorder (SUD) may qualify for an exception to the standard presumptive UDT annual limits.
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.
Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.
Contrast (contrast-enhanced) echocardiography is covered when conventional echocardiographic studies were inconclusive and contrast enhancement is needed to complete diagnostic evaluation.
Repeat echocardiographic studies are covered to monitor changes in cardiac structure or function when there is a change in clinical status or when disease progression is suspected.

L34645 — Urine Drug Testing

J05

L34624 — Somatosensory Testing

J05

A56915 — Billing and Coding: Urine Drug Testing

J05

A57597 — Billing and Coding: Somatosensory Testing

J05

L39611 — Urine Drug Testing

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