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ICD-10 Updates to Preauthorization Requirements Starting Oct. 1, 2024
Date Posted: 11/25/2024
The following procedure and diagnosis code requirements have been updated to include new ICD-10 codes effective Oct. 1, 2024.
For all sites of service, preauthorization is only required if one of the CPT/HCPCS codes shown in the table below is submitted with a diagnosis code in these ranges:
- C81.00-C88.91
- C91.00-C91.02
| CPT/HCPCS Code | CPT Code Description |
|---|---|
38206 |
Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous |
38999 |
Unlisted procedure, hemic or lymphatic system |
The ICD-10 codes shown in the table below in the range C81-C96 (malignant neoplasms of lymphoid, hematopoietic, and related tissue) were added to the EmblemHealth Preauthorization List starting Oct. 1, 2024.
| New ICD-10 Codes Added to Preauthorization List Requirements | ||||||
|---|---|---|---|---|---|---|
| C81.0A | C81.1A | C81.2A | C81.3A | C81.4A | C81.7A | C81.9A |
| C82.0A | C82.1A | C82.2A | C82.3A | C82.4A | C82.5A | C82.6A |
| C82.8A | C82.9A | C83.0A | C83.1A | C83.390 | C83.398 | C83.3A |
| C83.5A | C83.7A | C83.8A | C83.9A | C84.0A | C84.1A | C84.4A |
| C84.6A | C84.7B | C84.9A | C84.AA | C84.ZA | C85.1A | C85.2A |
| C85.8A | C85.9A | C86.00 | C86.01 | C86.10 | C86.11 | C86.20 |
| C86.21 | C86.30 | C86.31 | C86.40 | C86.41 | C86.50 | C86.51 |
| C86.60 | C86.61 | C88.00 | C88.01 | C88.20 | C88.21 | C88.30 |
| C88.31 | C88.40 | C88.41 | C88.80 | C88.81 | C88.90 | C88.91 |
JP 56610 11/2024