PA Lookup
If you have questions about prior authorizations, please call:
Member and Recipient Service Line: 1-877-685-2415
Provider Support Service Line: 1-855-250-1539
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
Multifetal pregnancy reduction(s) (MPR)
How to Submit
N/A - No authorization is required
1E-2 Therapeutic and Non-therapeutic Abortions
Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).
Limits
A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.
Place of Service
Inpatient, Outpatient Hospital, Office
How to Submit
N/A - No authorization is required
Resources
Removal of cerclage suture under anesthesia (other than local)
How to Submit
N/A - No authorization is required
Unlisted fetal invasive procedure, including ultrasound guidance, when performed
Authorization Guidelines
Please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.
How to Submit
Please submit your request to Trillium Health Resources
Unlisted laparoscopy procedure, maternity care and delivery
Authorization Guidelines
Please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.
How to Submit
Please submit your request to Trillium Health Resources
Unlisted procedure, maternity care and delivery
Authorization Guidelines
Please submit any records and any other information that you believe support the member has met the applicable medical necessity criteria to Trillium.
How to Submit
Please submit your request to Trillium Health Resources
Incision and drainage of thyroglossal duct cyst, infected
How to Submit
N/A - No authorization is required
Biopsy thyroid, percutaneous core needle
How to Submit
N/A - No authorization is required
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