Z87.898 — Personal history of other specified conditions
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- No specific documentation requirements, prior authorization criteria, or required clinical documentation are specified in this CPB for behavioral vision therapy or vision restoration therapy.
- General clinical rationale in the policy cites lack of validated evidence from well-designed prospective clinical studies as the basis for considering these therapies experimental/investigational.
Key Coverage Criteria
- Thyroid function testing is consideredmedically necessaryfor individuals who meet any of the following indications:
- For evaluation of signs or symptoms consistent with thyroid disease;or
- To evaluate, assess, or monitor confirmed or suspected thyroid disease;or
- To evaluate thyroid function when there are risk factors for thyroid disease.
2 Active Policies
AETNA-CPB-0321 — Behavioral Vision Therapy and Vision Restoration Therapy
ANTHEM-CG-LAB-20 — CG-LAB-20 Thyroid Testing
Related Codes
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