R78.71 — Abnormal lead level in blood
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This article provides billing, coding and guideline information that complements Local Coverage Determination (LCD) L33431 for HbA1c; refer to LCD L33431 for clinical coverage criteria and specific documentation requirements.
- Medical records must document the medical necessity of the serum magnesium test, including the signs, symptoms, and/or diagnosis that prompted the test.
- Laboratories must maintain the physician's order for the serum magnesium test in their records.
- Medical records must contain the serum magnesium lab test results.
Key Coverage Criteria
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D56.1 - Beta thalassemia
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.02 - Hb-SS disease with splenic sequestration
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.1 - Sickle-cell disease without crisis
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.212 - Sickle-cell/Hb-C disease with splenic sequestration
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.412 - Sickle-cell thalassemia, unspecified, with splenic sequestration
- ICD-10-CM Codes that Support Medical Necessity — Group 1 (covered diagnoses): D57.812 - Other sickle-cell disorders with splenic sequestration
11 Active Policies
A57198 — Billing and Coding: Serum Magnesium
ANTHEM-CG-LAB-21 — CG-LAB-21 Serum Iron Testing
ANTHEM-CG-MED-90 — CG-MED-90 Chelation Therapy
ANTHEM-CG-LAB-30 — CG-LAB-30 Outpatient Laboratory-based Blood Glucose Testing
A56686 — Billing and Coding: HbA1c
Related Codes
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