Updated Prior Authorization Requirement: Abortion Services
Meridian recently discovered following abortion codes were inadvertently changed to no pre-authorization required. These codes will again require prior authorization effective September 19, 2024.
Reminders:
- Please include a completed MSA-4240 along with supporting documentation when submitting a prior authorization request for these services.
- Please include a completed MSA-1550 form with your claim submission.
| Code | Description |
|---|---|
59841 | INDUCED AB BY DILAT & EVACUATION |
59840 | INDUCED AB BY DILAT & CURET |
59857 | INDUCED AN-VAG SUPPOS W/WO CERV DIL; W/HYSTEROT |
S0191 | MISOPROSTOL ORAL 200 MCG |
S0199 | MED INDUCED ABORTION BY ORAL INGEST OF MEDS INCL ALL ASSOC SVC & SUPPL |
59850 | INDUCED AB BY INTRA-AMNIOTIC INJ INCL HOSP ADMIN |
59851 | INDUCED AB BY INTRA-AMNIOTIC INJ; W/D&C |
59852 | INDUCED AB BY INTRA-AMNIOTIC INJ; W/HYSTEROTOMY |
59855 | INDUCED AB BY VAG SUPPOS W/WO CERV DIL; |
59856 | INDUCED AB-VAG SUPPOS W/WO CERV DIL; W/D&C/EVAC |
59857 | INDUCED AB-VAG SUPPOS W/WO CERV DIL; W/HYSTEROT |
59866 | MULTIFETAL PG REDUCTION(S) |
Resource Links from Michigan.gov:
Certification for Induced Abortion (PDF)
Beneficiary Verification of Coverage (PDF)