T82.868A — Thrombosis due to vascular prosthetic devices, implants and grafts, initial encounter
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Claims must be submitted with an ICD-10-CM code that represents the reason the procedure was performed, billed to the highest level of specificity, and linked to the appropriate CPT/HCPCS procedure code.
- All documentation must be maintained in the patient's medical record, with every page legible, including appropriate patient identification and dates of service, and must include the legible signature of the physician or responsible non-physician practitioner.
- The submitted medical record must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
- Medical record documentation should list the type and duration of conservative (non-stent) treatment attempted, as applicable per the LCD.
Key Coverage Criteria
- Endovenous stenting is covered when used to treat severely symptomatic venous obstructions in accordance with LCD L38231.
- MRA is covered to evaluate blood flow in the internal carotid vessels of the head and neck.
- MRA of peripheral arteries of the lower extremities is covered to determine the presence and extent of peripheral vascular disease and may substitute for conventional angiography (CA).
- MRA is covered for pre-operative evaluation of patients undergoing elective abdominal aortic aneurysm (AAA) repair when it is comparable to CA for determining extent of AAA and evaluating aortoiliac occlusive disease and renal artery pathology necessary for surgical planning.
- MRA of the renal arteries and aortoiliac arteries (in the absence of AAA or aortic dissection) is covered when MRA is expected to avoid CA, physician history/physical and standard assessments are insufficient, and obtaining MRA has a high probability of positively affecting patient management.
- MRA of the chest is covered for diagnosis of suspected pulmonary embolism when the patient has a contraindication to receiving intravascular iodinated contrast material.
20 Active Policies
A57594 — Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
J05
A57591 — Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies
J05
A57593 — Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies
J05
L35755 — Non-Invasive Abdominal / Visceral Vascular Studies
J05
Related Codes
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