S15.9XXA — Injury of unspecified blood vessel at neck level, initial encounter
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- 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.
- Images must be stored on conventional film or electronic media and the patient radiation dose should be recorded in the patient's permanent medical record.
Key Coverage Criteria
- 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.
- Contrast angiography is medically necessary to define the presence or extent of vascular occlusive disease and thromboembolic phenomena.
- Angiography is indicated to determine the etiology of hemorrhage when vascular imaging is required to identify bleeding source.
- Angiography is indicated to delineate the vascular supply of tumors for diagnostic or therapeutic planning.
- Angiography is indicated to outline vascular anatomy for planning and determining effects of therapeutic procedures.
- Angiography is indicated to identify the presence, location, and anatomy of extracranial and intracranial aneurysms and vascular malformations.
2 Active Policies
A56631 — Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
J12
L35035 — Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
J12
Related Codes
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