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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 CodeCPT 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
C81.0AC81.1AC81.2AC81.3AC81.4AC81.7AC81.9A
C82.0AC82.1AC82.2AC82.3AC82.4AC82.5AC82.6A
C82.8AC82.9AC83.0AC83.1AC83.390C83.398C83.3A
C83.5AC83.7AC83.8AC83.9AC84.0AC84.1AC84.4A
C84.6AC84.7BC84.9AC84.AAC84.ZAC85.1AC85.2A
C85.8AC85.9AC86.00C86.01C86.10C86.11C86.20
C86.21C86.30C86.31C86.40C86.41C86.50C86.51
C86.60C86.61C88.00C88.01C88.20C88.21C88.30
C88.31C88.40C88.41C88.80C88.81C88.90C88.91

 

JP 56610 11/2024

Testing the global alert and cta bar