Does S24.159A require prior authorization?

No, S24.159A does not require prior authorization (high confidence). Code is covered without prior authorization.

`S24.159A` — Other incomplete lesion at unspecified level of thoracic spinal cord, initial encounter

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

All documentation must be maintained in the medical record, be legible, include patient identification (e.g., full name, dates of service), and include the legible signature of the treating physician or non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s) and the CPT/HCPCS code must accurately describe the service performed.
When Q7, Q8, or Q9 is used, the medical record must document the specific Class A, B, and/or C findings and the complicating condition(s) that justify the modifier.
For podiatrist-submitted claims with ICD-10 codes marked with an asterisk, the claim must include the name of the M.D., D.O., or non-physician practitioner who diagnosed the complicating condition and the approximate date the beneficiary was last seen by that provider.

Routine foot care is covered only when the patient has one or more diagnoses listed in the LCD L33941 “ICD-10 Codes that Support Medical Necessity.”
Patients with peripheral neuropathy involving the feet (without vascular impairment) are covered when billed with the Group 3 ICD-10 codes appropriate for peripheral neuropathy.
Patients requiring anticoagulation therapy are covered when billed with the Group 4 ICD-10 codes documenting anticoagulation-related risk.
Patients with Group 2 (complicating) diagnoses may be covered when the claim includes the appropriate Q modifier (Q7, Q8, or Q9) and the medical record documents the required Class A, B, and/or C findings per the definitions.
Urodynamic testing is covered when medical necessity is documented consistent with the related Local Coverage Determination (LCD) for Urodynamics.
Somatosensory evoked potential (SEP) testing should be billed using CPT codes 95925, 95926, 95927, or 95938 when an SEP study (not QST) is performed.

A57455 — Billing and Coding: Urodynamics

J06

L33576 — Urodynamics

J06

A57188 — Billing and Coding: Routine Foot Care

A57540 — Billing and Coding: Somatosensory Testing

L33941 — Routine Foot Care

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