Important Update: Documentation Required for Unlisted, NOC, and Miscellaneous Codes Effective 02/15/2026

Date: 01/15/26

As a reminder, all claims submitted with unlisted procedure codes, not otherwise classified (NOC) codes, or miscellaneous codes must include supporting documentation that clearly describes the services and procedures performed. This requirement applies even if prior authorization has been approved.

An approved prior authorization does not guarantee payment. Documentation is necessary to ensure accurate code selection and compliance with Medicaid and CMS guidelines.

Why This Matters

Including complete documentation helps avoid claim denials and payment delays. While certain services may appropriately require unspecified codes, they must be accompanied by clear descriptions for proper claim review and reimbursement consideration.

For additional guidance, refer to:

• https://www.mdch.state.mi.us/dch-medicaid/manuals/MedicaidProviderManual.pdf 
• https://www.mimeridian.com/providers/resources/medical-policies.html

If you have questions, feel free to reach out to our Provider Relations team by submitting a Provider Relations Intake form.

Thank you for your attention to this important update and for your continued partnership in delivering quality care.