Does S15.8XXA require prior authorization?

No, S15.8XXA does not require prior authorization (high confidence). Code is covered without prior authorization.

`S15.8XXA` — Injury of other specified blood vessels at neck level, initial encounter

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Claims must meet the reasonable and necessary documentation requirements specified in LCD L35035; include clinical records demonstrating medical necessity per the LCD.
Follow the NCCI Coding Policy Manual (Chapters V and IX) for proper coding; retain documentation supporting compliance with NCCI edits.
When billing services that the LCD does not cover, use the appropriate Medicare modifier and document the basis for billing a non-covered service.
For services requiring a referring/ordering physician, the claim must report the referring/ordering physician's name and NPI.

Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.
MRA of the renal arteries and aortoiliac arteries (in the absence of AAA or aortic dissection) is covered when MRA is expected to avoid CA, physician history/physical and standard assessments are insufficient, and obtaining MRA has a high probability of positively affecting patient management.
MRA of the chest is covered for diagnosis of suspected pulmonary embolism when the patient has a contraindication to receiving intravascular iodinated contrast material.

A57592 — Billing and Coding: Non-Invasive Cerebrovascular Studies

J05

L35753 — Non-Invasive Cerebrovascular Studies

J05

A56747 — Billing and Coding: Magnetic Resonance Angiography (MRA)

J06

L33633 — Magnetic Resonance Angiography (MRA)

J06

A57056

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