T17.518S — Gastric contents in bronchus causing other injury, 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 follow the complementary Local Coverage Determination (LCD L34430) and, when CPT 97000–97799 are used by PT/OT, must include documentation that the services meet the coverage and documentation requirements for physical or occupational therapy.
- Document evaluations and re-evaluations and bill re-evaluations using the evaluation CPT code (per policy guidance).
- Document selection/prescription and programming/modification of speech-generating devices and use CPT 92607/92608 for selection/prescription and CPT 92609 for programming/modification on claims.
Key Coverage Criteria
- Therapeutic procedures whose principal aim is to treat a respiratory impairment must be billed using HCPCS codes G0237, G0238, or G0239.
- Coverage for programming and modification of speech-generating devices using CPT 92609.
- Coverage for individual outpatient treatment of speech, language, voice, communication, and/or auditory processing disorders using CPT 92507.
- Coverage for group outpatient treatment (2 or more individuals) of speech, language, voice, communication, and/or auditory processing disorders using CPT 92508.
- Coverage for selection and prescription of speech-generating devices (SGDs) using CPT 92607 and 92608.
- CT thorax is covered for diagnosis and/or staging of neoplastic and hematologic processes arising in or involving the thorax.
6 Active Policies
A56580 — Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56717 — Billing and Coding: Respiratory Therapy (Respiratory Care)
A56868 — Billing and Coding: Outpatient Speech Language Pathology
L34430 — Respiratory Therapy (Respiratory Care)
L34429 — Outpatient Speech Language Pathology
Related Codes
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