Z79.82 — Long term (current) use of aspirin
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing and coding guidance complements Local Coverage Determination L34434; follow LCD L34434 for clinical coverage criteria and required documentation for claims.
- All services billed with unlisted procedure codes must include sufficient medical records and supporting documentation to allow development and medical review.
- The patient's medical record must contain documentation that fully supports the medical necessity for the visual fields testing in accordance with the applicable LCD.
- Documentation should include relevant medical history, a physical examination, and results of pertinent diagnostic tests or procedures supporting the need for visual fields testing.
Key Coverage Criteria
- Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and necessary.
- For diagnostic visual field tests, report the test result on the claim if known; if the result is not known, report the signs or symptoms that prompted the test.
- If the service requires a referring/ordering physician, include the ordering/referring physician’s name and NPI on the claim.
- Upper gastrointestinal endoscopy (diagnostic or therapeutic) is covered when determined reasonable and necessary per Local Coverage Determination L35350.
- Vitamin D assay testing is covered when the medical record documents medical necessity for the test, including the clinical reason for testing and any planned repeat testing and frequency.
- Formal visual field testing is medically necessary for patients with a disorder of the eyelid(s) that may affect the visual field.
13 Active Policies
L37535 — Vitamin D Assay Testing
J06
A56551 — Billing and Coding: Visual Fields Testing
J06
A57736 — Billing and Coding: Vitamin D Assay Testing
J06
L33574 — Visual Fields Testing
J06
L35350 — Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Related Codes
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