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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.
CodeDescription

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: 

 

Last Updated: 11/25/2024