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October 20, 2022

Tennessee Medicaid: Prior authorization updates for abortion services

Effective Nov. 1, 2022, UnitedHealthcare Community Plan of Tennessee will require prior authorization for several abortion Current Procedural Terminology (CPT®) codes.

View the table below for the list of impacted codes.

Code Description
59840 Induced abortion, by dilation and curettage
59841 Induced abortion, by dilation and evacuation
59850 Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines
59851 Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections) including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation
59852 Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines, with hysterotomy (failed intra-amniotic injection)
59855 Induced abortion, by 1 or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines
59856 Induced abortion, by 1 or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation
59857 Induced abortion, by 1 or more vaginal suppositories (e.g., prostaglandin) with or without cervical dilation (e.g., laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)
59866 Multifetal pregnancy reduction(s) (MPR)

How to submit prior authorization

Submit your prior authorization request on the UnitedHealthcare Provider Portal using your One Healthcare ID. For more information about the process and resources, visit the Prior Authorization and Notification page.

Questions?

Call Provider Services at 866-604-3267.

CPT® is a registered trademark of the American Medical Association.
PCA-1-22-03155-C&S-News
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