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MedicaidBilling CodesMedium impact

MSA 21-18

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid updated billing codes and prior authorization requirements effective April 1, 2021, adding new HCPCS codes for various provider types and discontinuing several existing codes. The provider manual was also updated with technical changes to prior authorization sections.

Action Required

Action needed
Billing team must update system to include new HCPCS codes J1427, J1554, J7402, J9037, J9349 for physicians and practitioners (J1427 requires prior authorization). Add code 0172U for clinical laboratories with prior authorization requirement. Remove discontinued codes 0098U, 0099U, 0100U, 0127U, C9068-C9073, C9122, J7333, J7401, K1010-K1012 from billing system. Update prior authorization rules to remove requirements for codes 81510, 81511, 81512 effective March 31, 2021.

Affected Billing Codes

J1427
J1554
J7402
J9037
J9349
91303
M0245
Q0245
81510
81511
81512
M0239
Q0239
C9068
C9069
C9070
C9071
C9072
C9073
C9122
J7333
J7401
K1010
K1011
K1012