Does R68.83 require prior authorization?

No, R68.83 does not require prior authorization (high confidence). Code is covered without prior authorization.

`R68.83` — Chills (without fever)

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification (e.g., complete name, dates of service).
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.

Respiratory pathogen panel testing is covered when performed in an outpatient, non-institutional Part B setting from a single biologic specimen on a single date of service and the order is not a reflex test.
Respiratory pathogen panel testing is covered when the medical record documents that the testing facility can deliver timely results and that the test results can reasonably be expected to change clinical management and improve patient health outcomes.
Respiratory pathogen panel testing is covered when performed as a single service from a single biologic specimen in the outpatient setting on a single date of service and is reasonable and necessary per LCD L38918.
The test is covered when performed in a Medicare Part B setting that is equipped to deliver timely results and when the results can reasonably be expected to lead to a change in clinical management that improves health outcomes.
Respiratory pathogen panel testing is covered when performed in an outpatient Medicare Part B setting using a single biologic specimen collected and tested on a single date of service, and the results are timely and can affect clinical management to improve patient health outcomes.
A panel is defined as all respiratory pathogens tested on that single specimen/date and is covered when ordered as a panel (not as a reflex test).

A56421 — Billing and Coding: CT of the Abdomen and Pelvis

A58575 — Billing and Coding: Respiratory Pathogen Panel Testing

A58577 — Billing and Coding: Respiratory Pathogen Panel Testing

A58741 — Billing and Coding: Respiratory Pathogen Panel Testing

L39027 — Respiratory Pathogen Panel Testing

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