ICD-10 Updates to Preauthorization Requirements Starting Oct. 1, 2024

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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