Molina Healthcare Michigan policy

Infertility Evaluation and Treatments

Infertility Evaluation and Treatments is a public Molina Healthcare Michigan policy (policy 476). It lists 162 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

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Payer
Molina Healthcare Michigan
Policy number
476
Line of business
Commercial, Medicaid
Source
www.molinaclinicalpolicy.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.

CodeOther Molina Healthcare Michigan policies
00092Policies naming 00092
00155Policies naming 00155
01971Policies naming 01971
0253UPolicies naming 0253U
0255UPolicies naming 0255U
02851Policies naming 02851
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55870Policies naming 55870
58140Policies naming 58140
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58146Policies naming 58146
58321Policies naming 58321
58322Policies naming 58322
58323Policies naming 58323
58340Policies naming 58340
58345Policies naming 58345
58350Policies naming 58350
58540Policies naming 58540
58545Policies naming 58545
58546Policies naming 58546
58555Policies naming 58555
58559Policies naming 58559
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58660Policies naming 58660
58662Policies naming 58662
58670Policies naming 58670
58672Policies naming 58672
58673Policies naming 58673
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58752Policies naming 58752
58760Policies naming 58760
58770Policies naming 58770
58800Policies naming 58800
58805Policies naming 58805
58920Policies naming 58920
58970Policies naming 58970
58974Policies naming 58974
58976Policies naming 58976
74440Policies naming 74440
74740Policies naming 74740
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76830Policies naming 76830
76831Policies naming 76831
76856Policies naming 76856
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76872Policies naming 76872
76948Policies naming 76948
80415Policies naming 80415
80426Policies naming 80426
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82024Policies naming 82024
82157Policies naming 82157
82166Policies naming 82166
82397Policies naming 82397
82627Policies naming 82627
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82671Policies naming 82671
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82681Policies naming 82681
83001Policies naming 83001
83002Policies naming 83002
83498Policies naming 83498
83520Policies naming 83520
84144Policies naming 84144
84146Policies naming 84146
84270Policies naming 84270
84402Policies naming 84402
84403Policies naming 84403
84410Policies naming 84410
84443Policies naming 84443
84830Policies naming 84830
86255Policies naming 86255
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88182Policies naming 88182
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88273Policies naming 88273
88280Policies naming 88280
88283Policies naming 88283
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89255Policies naming 89255
89257Policies naming 89257
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89259Policies naming 89259
89260Policies naming 89260
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89264Policies naming 89264
89268Policies naming 89268
89272Policies naming 89272
89280Policies naming 89280
89281Policies naming 89281
89290Policies naming 89290
89291Policies naming 89291
89300Policies naming 89300
89310Policies naming 89310
89320Policies naming 89320
89321Policies naming 89321
89322Policies naming 89322
89325Policies naming 89325
89329Policies naming 89329
89330Policies naming 89330
89331Policies naming 89331
89335Policies naming 89335
89337Policies naming 89337
89342Policies naming 89342
89343Policies naming 89343
89344Policies naming 89344
89346Policies naming 89346
89352Policies naming 89352
89353Policies naming 89353
89354Policies naming 89354
89356Policies naming 89356
89398Policies naming 89398
G0027Policies naming G0027
J0725Policies naming J0725
J3355Policies naming J3355
Q0115Policies naming Q0115
S0015Policies naming S0015
S0122Policies naming S0122
S0126Policies naming S0126
S0128Policies naming S0128
S0132Policies naming S0132
S3655Policies naming S3655
S4011Policies naming S4011
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S4017Policies naming S4017
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S4020Policies naming S4020
S4021Policies naming S4021
S4022Policies naming S4022
S4023Policies naming S4023
S4025Policies naming S4025
S4026Policies naming S4026
S4027Policies naming S4027
S4028Policies naming S4028
S4030Policies naming S4030
S4031Policies naming S4031
S4035Policies naming S4035
S4037Policies naming S4037
S4040Policies naming S4040
S4042Policies naming S4042

All Molina Healthcare Michigan policies · Molina Healthcare Michigan prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.