Does S36.115D require prior authorization?

No, S36.115D does not require prior authorization (high confidence). Code is covered without prior authorization.

`S36.115D` — Moderate laceration of liver, subsequent encounter

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information such as complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.

Diagnostic abdominal aortography and renal angiography are covered when they meet the reasonable and necessary clinical requirements specified in LCD L35092.
When femoral or iliac angiography is performed at the time of coronary angiography, bill using HCPCS code G0278.
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 abdomen is medically necessary to evaluate abdominal pain.
CT abdomen is medically necessary to evaluate known or suspected abdominal masses or fluid collections.

A57056 — Billing and Coding: Aortography and Peripheral Angiography

J09

L36767 — Aortography and peripheral angiography

J09

A56682 — Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography

J12

L35092 — Diagnostic Abdominal Aortography and Renal Angiography

J12

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