Does Z98.83 require prior authorization?

No, Z98.83 does not require prior authorization (high confidence). Code is covered without prior authorization.

`Z98.83` — Filtering (vitreous) bleb after glaucoma surgery status

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
Medical record documentation by the ordering/referring physician must state the clinical indication/medical necessity for the test and include the test results.
If the performing provider is different from the ordering/referring physician, the performing provider must maintain hard copy test results and interpretation plus copies of the ordering/referring physician's order.
Documentation should contain a history and physical (H&P) supporting the diagnosis for which the corneal pachymetry is being rendered.

Corneal pachymetry (measurement of corneal thickness) is covered to evaluate patients with a diagnosis of increased intraocular pressure.
Repeat corneal pachymetry is covered after interval corneal trauma or corneal surgery to reassess corneal thickness.
Corneal pachymetry is generally covered when performed as indicated by current medical literature or accepted standards of practice for clinical management.
Computerized corneal topography is billable when performed as a diagnostic test for corneal conditions and the claim includes a diagnosis code that best describes the patient's condition for which the service was performed.
Corneal pachymetry is medically necessary to determine the amount of endothelial trauma sustained during intraocular surgery.
Corneal pachymetry is medically necessary for preoperative assessment of corneal health in patients with Fuchs dystrophy.

A56548 — Billing and Coding: Corneal Pachymetry

J06

L33630 — Corneal Pachymetry

J06

AETNA-CPB-0749 — Anterior Segment Scanning Computerized Ophthalmic Diagnostic Imaging

A56816 — Billing and Coding: Computerized Corneal Topography

L34008 — Computerized Corneal Topography

Ask Verity about documentation requirements, denial risks, or coverage in your state.