Z49.01 — Encounter for fitting and adjustment of extracorporeal dialysis catheter
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- No specific documentation requirements, required medical records, or test-result documentation are stated in this policy.
- Avian influenza A virus (H5N1): documentation of symptoms consistent with Avian influenza A virus and history of travel to or contact with persons or birds from a country with documented H5N1 avian influenza infections within 10 days of symptom onset.
- Cerebrospinal fluid (CSF) pathogen panel: Member has clinical findings consistent with a central nervous system (CNS) infection (e.g., meningitis, encephalitis); and viral etiology is suspected or the CSF culture is inconclusive for pathogen etiology (i.e., viral, bacterial, fungal).
- Coronavirus COVID-19 respiratory panel (up to 5 respiratory pathogens): Member has signs and symptoms of COVID-19 and test will be used to guide therapy.
Key Coverage Criteria
- No covered indications identified. Hemodialysis for the treatment of schizophrenia is considered experimental and investigational because the effectiveness of this approach has not been demonstrated and established.
- Acanthamoeba in corneal ulceration
- Actinomyces, for identification of actinomyces species in tissue specimens
- Adenovirus, to diagnose adenovirus myocarditis, and to diagnose adenovirus infection in immunocompromised hosts, including transplant recipients
- Anaplastic lymphoma kinase (ALK) testing as an alternative to FISH for selecting individuals for ALK inhibitor therapy
- Avian influenza A virus, for diagnosis of avian influenza A (H5N1) in persons with both: Symptoms consistent with Avian influenza A virus (see background); and A history of travel to or contact with persons or birds from a country with documented H5N1 avian influenza infections within 10 days of symptom onset.
2 Active Policies
AETNA-CPB-0291 — Hemodialysis for Schizophrenia
AETNA-CPB-0650 — Polymerase Chain Reaction Testing: Selected Indications
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.