Z68.56 — Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Inherited disorders of vitamin D and phosphate metabolism;or
- Immobilization (for example, cerebral palsy or neuromuscular disease);or
- Hepatic failure (cirrhosis or chronic liver disease);or
- Hypo- or hyper-calcemia;or
- Vitamin D testing is consideredmedically necessaryin individuals with conditions considered high-risk for vitamin D deficiency or intoxication, including but not limited to:
- Aggressive sun protection measures (that is, limited effective sun exposure due to protective clothing or consistent use of sunscreens);or
5 Active Policies
ANTHEM-CG-LAB-11 — CG-LAB-11 Vitamin D Testing
ANTHEM-CG-SURG-83 — CG-SURG-83 Bariatric Surgery and Other Treatments for Clinically Severe Obesity
ANTHEM-CG-LAB-29 — CG-LAB-29 Gamma Glutamyl Transferase Testing
ANTHEM-CG-LAB-25 — CG-LAB-25 Outpatient Glycated Hemoglobin and Protein Testing
ANTHEM-CG-LAB-30 — CG-LAB-30 Outpatient Laboratory-based Blood Glucose Testing
Related Codes
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