Does T78.00XS require prior authorization?

No, T78.00XS does not require prior authorization (high confidence). Code is covered without prior authorization.

`T78.00XS` — Anaphylactic reaction due to unspecified food, sequela

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Policy references and complements Local Coverage Determination L33417 for Allergy Skin Testing; full LCD and policy text required to determine specific documentation and billing rules.
This article provides billing/coding guidelines that complement Local Coverage Determination L34417 for CT of the head; consult LCD L34417 for specific coverage, coding, and documentation requirements.
The patient's medical record must contain documentation that fully supports medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each claim must be submitted with ICD-10-CM code(s) that reflect the patient's condition and indicate the reason(s) the service was performed; claims without ICD-10-CM codes will be returned.

RAST type tests are covered when medically necessary and supported by the related Local Coverage Determination (LCD) and current medical literature or standards of practice.
External ocular photography is covered when ordered by an authorized/referring provider to document, diagnose, or monitor an ocular condition and when medical record documentation supports medical necessity.
External ocular photographs are covered to track changes in a patient's ocular condition provided changes are documented in writing and compared to prior photographs when available.
Technical (TC) and professional (26) components of external ocular photography are payable under Part B when billed with the appropriate modifier and performed in allowable places of service as specified by Medicare.
An ECG is covered when the result is relevant to the management, diagnosis, or treatment of the patient.
A separate ECG on the same day as a cardiac stress test is payable only when it provides additional clinically necessary information beyond the stress test (e.g., to rule out acute myocardial infarction prior to performing the stress test).

A57473 — Billing and Coding: Allergy Testing

J05

L36402 — Allergy Testing

J05

L33591 — RAST Type Tests

J06

A56844 — Billing and Coding: RAST Type Tests

J06

L35049 — Monitored Anesthesia Care

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