MedicaidPrior AuthMedium impact
Inpatient delivery stays denying due to lack of prior authorization when the delivery stays do not require prior authorization
Connecticut Medicaid (HUSKY Health)·CT · OB-GYN·Prior Authorization
Effective date
Mar 30, 2016
We identified it
Jun 20, 2026
Summary
The Department of Social Services updated their system on March 30, 2016 to allow additional ICD-10 diagnosis codes to bypass prior authorization requirements for inpatient delivery stays. When these specific delivery-related diagnosis codes are used as the primary diagnosis, prior authorization will no longer be required.
Action Required
Immediately: Billing team must update system rules to remove prior authorization requirements for inpatient delivery stays when the listed ICD-10 diagnosis codes are used as the primary diagnosis. Update billing software to automatically bypass PA requirements for these specific delivery-related codes. Review any previously denied delivery claims with these diagnosis codes for potential reprocessing.