S25.102S — Unspecified injury of left innominate or subclavian artery, sequela
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing/coding guideline complements LCD L33459 (Computerized Axial Tomography (CT), Thorax); follow the LCD for clinical coverage and any required documentation or prior authorization rules.
- 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.
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.
- Bill HCPCS code G0278 for femoral or iliac angiography performed at the time of coronary angiography.
- Aortography and peripheral angiography are covered when reasonable and necessary per Local Coverage Determination L36767 and when documentation supports the selected ICD-10-CM diagnosis and medical necessity.
- CT thorax is covered for diagnosis and/or staging of neoplastic and hematologic processes arising in or involving the thorax.
- CT thorax is covered to evaluate pulmonary, mediastinal, pleural, and chest wall infections and their complications.
- CT thorax is covered to detect and characterize mediastinal neoplasms and other mediastinal processes.
6 Active Policies
A57056 — Billing and Coding: Aortography and Peripheral Angiography
J09
L36767 — Aortography and peripheral angiography
J09
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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