The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
The MHD’s Radiology Benefit Manager is currently auto approving Chest CT Scan HCPCS codes 71250, 71260, and 71270 when the following COVID-19 related diagnosis codes are present: B34.2, B97.29, J20.8, J22, J40, J80, J98.8, Z03.818, and Z20.828. The prior authorizations for these tests will be approved for 90 days.
The MHD is working to update the claims processing system to waive the prior authorization requirements for these tests when the above diagnosis codes are present. Providers must continue to submit prior authorization requests by using the web tool, Cyber Access, or by calling the MO HealthNet Call Center at (800) 392-8030, option 5, until the system work to waive the prior authorization requirements is complete.
The MO HealthNet Division is also waiving the co-payment for these codes.