T50.914S — Poisoning by multiple unspecified drugs, medicaments and biological substances, undetermined, sequela
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- For services that require a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.
- The claim must include a valid ICD-10-CM diagnosis code that best describes the patient's condition for which the urine drug test was performed.
- For diagnostic urine drug tests, report the test result if known; if the result is not known, report the symptoms that prompted the performance of the test.
- This billing and coding guidance complements Local Coverage Determination L35724 and providers should follow LCD L35724 in conjunction with NCCI/OPPS rules when preparing claims.
Key Coverage Criteria
- No specific clinical indications are listed in this article; follow the Local Coverage Determination (LCD) L39400 for indications for magnesium testing or services.
- When a referring/ordering physician is required by the service or LCD, the test is covered if the ordering/referring physician is documented and the order meets the Local Coverage Determination criteria.
- Urine drug testing performed as a diagnostic test or for clinical monitoring when there is a documented medical indication and a valid ICD-10-CM diagnosis code that best describes the patient's condition.
- Cranial CT (with or without contrast) is covered when the patient has clinical evidence of an intracranial disorder or an established intracranial disorder/disease.
- Contrast-enhanced CT is reasonable and necessary to assess cerebral perfusion, for example in suspected or known cerebrovascular accident (CVA).
- Contrast-enhanced CT is covered to characterize a specific intracranial lesion.
10 Active Policies
A59416 — Billing and Coding: Urine Drug Testing
J06
L39611 — Urine Drug Testing
J06
A56612 — Billing and Coding: CT of the Head
A59186 — Billing and Coding: Magnesium
L34417 — CT of the Head
Related Codes
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