MedicaidPrior AuthMedium impact
COVID-19: Radiology (Diagnosis Codes Added effective 1/1/21)
Missouri Medicaid (MO HealthNet)·MO · Radiology, Pulmonology, Emergency Medicine +3 more·Coding
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
MO HealthNet Division added 6 new COVID-19 related diagnosis codes (Z11.52, Z20.822, Z86.16, M35.81, M35.89, J12.82) effective January 1, 2021, that allow chest CT scans without prior authorization. These codes join the existing list of COVID-19 diagnoses that waive prior auth requirements for specific radiology procedures.
Action Required
Immediately: Billing team must update system to recognize the 6 new COVID-19 diagnosis codes (Z11.52, Z20.822, Z86.16, M35.81, M35.89, J12.82) that waive prior authorization for chest CT scans (71250, 71260, 71270). Update encounter forms and EMR templates to include these new qualifying diagnosis codes for COVID-19 related radiology procedures.