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ICD-10-CM T79.A0XS — Compartment syndrome, unspecified, sequela | No Prior Auth

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`T79.A0XS` — Compartment syndrome, unspecified, sequela

ICD-10-CM

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Key Coverage Criteria

Cyanide poisoning;or
Decompression sickness;or
Systemic hyperbaric oxygen pressurization is consideredmedically necessaryin the treatment of any of the following conditions when performed in accordance with Undersea and Hyperbaric Medical Society (UHMS) guidelines:
Acute peripheral arterial insufficiency;or
Acute thermal burns: deep second degree or third degree in nature;or
Acute traumatic ischemia;or

1 Active Policy

ANTHEM-CG-MED-73 — CG-MED-73 Hyperbaric Oxygen Therapy (Systemic/Topical)

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