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COVID-19: Radiology, Revised April 3, 2020

Information from our lawyer:

April 3, 2020

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”).

Effective with dates of service on or after March 1, 2020 providers do not need to obtain prior authorization for Chest CT Scan HCPCS codes 71250, 71260, and 71270 when the following COVID-19 related diagnosis codes are present: B34.2, B97.29, J1289, J20.8, J22, J40, J80, J98.8, R05, R0602, R509, Z03.818, and Z20.828. The MHD will continue to waive the co-payment for these codes.

Prior authorizations for ALL procedures managed by the MHD’s RBM will be approved for 90 days during the COVID-19 crisis. The list of procedures the RBM manages can be found here:

This Hot Tip also applies to providers that are contracted with the Managed Care Organizations.

Harvey M. Tettlebaum