MedicaidPrior AuthMedium impact
Inpatient Hospital Providers - Inpatient delivery stays denying due to lack of prior authorization when the delivery stays do not require prior authorization
Connecticut Medicaid (HUSKY Health)·OB-GYN·Prior Authorization
Effective date
Mar 7, 2016
We identified it
Jun 20, 2026
Summary
Effective March 7, 2016, the Department of Social Services updated their system 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 is no longer required for the inpatient stay.
Action Required
Immediately: Billing team must update system settings to recognize that inpatient delivery stays with the listed ICD-10 codes as primary diagnosis do not require prior authorization. Review any previously denied claims for inpatient deliveries with these diagnosis codes and consider resubmission. For additional delivery-related codes that may need PA bypass, submit claim examples with ICN to ctxixhosppay@hpe.com.