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Banner # Date Topics Type
BR202007 2/18/2020 IHCP establishes PA criteria for Zolgensma; IHCP reminds providers of option to void and replace FFS claims All, Pharmacy/Prescribing, Physician/Practitioner
BR202006 2/11/2020 PERM FY 2017 federal audit findings and requirements to maintain records; Changes to the process for faxing prior authorization requests and supporting documents; IHCP reminds providers of new prior authorization customer service line via the IVR system; IHCP corrects limit on daily rate billing for assisted living services under code T2031 All, Home Health
BR202005 2/4/2020 IHCP to remove PA requirement for billing dental codes D5282 and D5283 for members under age 21; IHCP corrects reimbursement rates for nursing facility services and will mass adjust claims that paid incorrectly; IHCP integrates prior authorization customer service line into the IVR system All, Dentist, Nursing Facility/Long Term Care
BR202004 1/28/2020 IHCP will add adjustment reason codes as valid for proof of primary insurer denied or zero-paid claims All
BR202003 1/21/2020 IHCP to cover HCPCS codes Q5114, and Q5115; IHCP removes age restriction on adult day services for A&D and TBI waivers, accepts resubmitted claims; IHCP assigns maximum fee pricing to CPT codes for outpatient services, accepts resubmitted claims; IHCP to mass reprocess claims for skilled nursing facility services that may have denied incorrectly; FSSA to host provider meeting on January 24, including information on new Medicaid waiver for SMI All, ASC, Clinic, Hospital, Mental Health, Nursing Facility/Long Term Care, Physician/Practitioner, Psychiatric Residential Treatment Facility, Waiver
BR202002 1/14/2020 IHCP to integrate prior authorization customer service line into the IVR system; IHCP corrects dates associated with CHW claims that denied incorrectly All, Clinic, Physician
BR202001 1/7/2020 IHCP to mass reprocess or mass adjust claims for cardiac catheterization-related procedures that priced incorrectly; IHCP updates procedure code/modifier combinations reimbursable for EMS hospital-to-hospital NEMT transfers, and mass reprocesses claims that denied inappropriately; New Program Integrity provider education training – Durable Medical Equipment Documentation and Billing Requirements ASC, DME, HME, Transportation
BR201953 12/31/2019 This banner page has been canceled.
BR201952 12/24/2019 This banner page has been canceled.
BR201951 12/17/2019 IHCP to mass reprocess or mass adjust claims for incontinence supplies that may have denied incorrectly; IHCP to remove age restriction on structured family caregiving waiver services under the A&D HCBS program, and accept resubmitted claims; CMS good faith exemption extends EVV soft launch All, DME, Waiver
BR201950 12/10/2019 IHCP will reimburse claims for NARCAN® when billed on CMS-1500 or UB-04 claim form; IHCP to mass reprocess or mass adjust claims for ABA services that may have denied incorrectly; IHCP to mass reprocess claims for ICD-10 diagnosis code Z99.89 that may have denied incorrectly; IHCP to mass reprocess or mass adjust claims for anesthesia services that denied incorrectly, and add Anesthesia Services Codes for CRNAs; IHCP adds procedure codes for speech therapy services to Telemedicine Services Codes All, Anesthesiologist, ASC, Hospital, Mental Health, Physician/Practitioner, Waiver
BR201949 12/3/2019 IHCP provider payment dates during the holidays All
BR201948 11/26/2019 Providers may resubmit outpatient claims billed with ICD-10 diagnosis code K35.80 that denied incorrectly; IHCP to remove gender restriction on ICD-10 diagnosis code Z79.890 and accept resubmitted claims; IHCP clarifies VFC and private stock vaccine reimbursement, effective January 1, 2020; IHCP to update CoreMMIS to capture fields present on standard national claim forms; New Program Integrity provider training available – Renal Dialysis Services Billing Guidelines All, Physician/Practitioner
BR201947 11/19/2019 IHCP to mass reprocess claims for PASRR services that may have denied inappropriately; IHCP to mass reprocess or mass adjust claims for outpatient services that may have denied inappropriately; CMS announces new provider enrollment application fee for 2020 ASC, Clinic, End-Stage Renal Disease Clinic, Hospital, Nursing Facility/Long Term Care, Physician-Practitioner, Public Health Agency
BR201946 11/12/2019 IHCP to cover HCPCS code Q5107 (Mvasi); Pricing updated for HCPCS code B4100 on professional claims; IHCP reminds providers of limit on reimbursement for infusion services in an outpatient setting All, DME, Clinic, End Stage Renal Disease, Hospital
BR201945 11/5/2019 IHCP to cover HCPCS code J7332; IHCP corrects rate for HCPCS code Q5106; IHCP to update age range for coverage of CPT code 90651 (HPV vaccine); IHCP intends to enroll additional behavioral health professionals; IHCP to enhance Portal for uploading unlimited provider enrollment attachments; IHCP to present live webinar about the provider enrollment process, December 3, 2019 All, Clinic, Hospital, Mental Health, Physician/Practitioner
BR201944 10/29/2019 IHCP to cover HCPCS code J1095 (Dexycu); IHCP to cover CPT code 22858; IHCP adds CPT code 64615 to Injections, Vaccines, and Other Physician-Administered Drugs Codes; IHCP clarifies billing requirements for mental health therapy services in outpatient facilities; Outpatient HAF applied to IHCP allowed amount, effective December 1, 2019; IHCP to present live webinar for VFC providers, November 12, 2019 All, Clinic, Hospital, Mental Health, Physician/Practitioner
BR201943 10/22/2019 This banner page has been canceled.
BR201942 10/15/2019 IHCP corrects anesthesia code sets update Anesthesiologist
BR201941 10/8/2019 IHCP to cover Zolgensma; IHCP clarifies billing for telemedicine services; Updated Medicaid Third-Party Liability Accident/Injury Questionnaire; IHCP corrects ICD-10 annual codes update; IHCP delays updates to rates and rate methodology for DME, HME, and eyeglasses frame and lens All, Clinic, Dentist, DME/HME, FQHC/RHC, Hospital, Optician, Optometrist, Physician/Practitioner, Podiatrist

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