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Banner # Date Topics Type
BR201846 11/13/2018 IHCP revises policy regarding outpatient mental health services limitations for certain procedure codes; IHCP reminds providers of the 180-day timely filing limit for FFS claims; IHCP reminds providers of cost-sharing obligation limit for Medicaid members; Portal enhanced to display Right Choices Program PMP when verifying member eligibility All, Mental Health
BR201845 11/6/2018 Clarification regarding physician-administered drugs carved out of managed care; CMS updates NCCI medically unlikely edits for HCPCS code J1726 Makena; IHCP to mass reprocess or mass adjust professional claims that adjudicated incorrectly in CoreMMIS All, ASC, DME, Hospital, Physician, Waiver
BR201844 10/30/2018 IHCP revises revenue codes for billing hospice services; IHCP to mass reprocess or mass adjust BPHC services claims that may have inappropriately denied; IHCP corrects system to apply unit limits on certain ABA therapy codes billed without modifiers; IHCP to assign ASC pricing indicators to cardiac catheterization-related procedure codes All, ASC, Clinic, Hospice, Hospital, Mental Heath, Physician
BR201843 10/23/2018 IHCP enhances Portal to allow electronic submission of CHOWs for extended care facilities; Code set corrected for provider specialty 250 DME/Medical Supply Dealer DME, Extended Care Facility
BR201842 10/16/2018 IHCP announces IEP-related nursing services rate for calendar year 2019 School corporation
BR201841 10/9/2018 This banner page has been canceled.
BR201840 10/2/2018 IHCP will reimburse for FluMist in the 2018-2019 flu season; IHCP removes gender restriction on ICD-10-CM code Z85.3; IHCP reminds hospice providers of face-to-face physician encounter requirement All, Hospice, Physician, Advanced Practice Nurse
BR201839 9/25/2018 Services rendered during the retroactive eligibility period for a Hoosier Healthwise member will be covered fee-for-service; IHCP enhances Portal with a pop-up message when a procedure code is entered on a PA request that does not typically require PA; IHCP updates the security policy on the Provider Healthcare Portal; IHCP to implement Portal enhancement for converting OPR and rendering provider classifications; IHCP corrects procedure code published in Banner Page BR201834 All, ASC, Hospital, OPR
BR201838 9/18/2018 IHCP to mass reprocess or mass adjust professional claims that denied inappropriately; IHCP to mass reprocess or mass adjust claims for services that denied inappropriately; IHCP eligibility verification systems to include tooth sealant information to support dental benefit limits; Procedure codes reimbursable in the outpatient setting and linked to revenue code 636 ASC, Dentist, DME, Hospital, Physician, Transportation
BR201837 9/11/2018 IHCP to mass adjust or mass reprocess outpatient claims for CPT code 95250 that may have denied inappropriately; OPR provider revalidation is quick and easy on the Portal; IHCP delays Portal enhancement for converting OPR and rendering provider classifications; Reminder: DXC email addresses changing from @HPE to @DXC All, Ambulatory Surgical Center, Clinic, Hospital, OPR
BR201836 9/4/2018 IHCP to reimburse cochlear device separately from outpatient implantation; HCPCS code L3923 covered in the outpatient setting and linked to revenue code 274 ASC, DME, Hospital, Physician, Podiatrist, Rehabilitation Facility
BR201835 8/28/2018 IHCP eligibility verification systems return clearer messages regarding member copayments; IHCP enhances Portal process for converting OPR and rendering provider classifications All, OPR
BR201834 8/21/2018 IHCP to cover HCPCS code J9320; HCPCS codes for certain brachytherapy services to be covered in the outpatient setting; IHCP to assign ASC pricing indicator to CPT code 21044; Providers may resubmit institutional claims for certain procedure codes that denied inappropriately; IHCP clarifies HCPCS code K0010 is noncovered; IHCP will mass reprocess crossover physician claims that may have denied inappropriately; HCPCS codes J2860 and J7503 linked to revenue code 636; IHCP to assign maximum fee pricing to CPT codes for outpatient services; IHCP to assign maximum fee pricing to procedure codes 88344 and G0416; HCPCS code J2724 linked to revenue codes 636; IHCP corrects system to apply tooth number restrictions on certain dental claims; IHCP revises EOB descriptions related to audit to enforce limits on clubhouse psychosocial rehabilitation services All, ASC, Dentist, DME, Hospital, Physician, Waiver
BR201833 8/14/2018 IHCP to mass reprocess or mass adjust transportation services claims that adjudicated incorrectly; IHCP implements claim-processing edit to enforce reimbursement limitations on clubhouse psychosocial rehabilitation services; IHCP to mass reprocess or mass adjust certain claims that denied incorrectly for exceeding PA units; IHCP enhances Portal to allow submission of electronic dental PA requests; Additional information to be required when providers revalidate enrollments on the Portal All, Dentist, Hospital, School Corporation, Transportation, Waiver
BR201832 8/7/2018 IHCP to cover CPT code 90750; IHCP will no longer allow outpatient reimbursement for certain procedure codes; IHCP to allow outpatient reimbursement for certain procedure codes; IHCP assigns maximum-fee pricing for HCPCS codes A9517 and A9563; IHCP to mass reprocess or mass adjust outpatient claims that may have adjudicated incorrectly; IHCP to assign ASC pricing indicators to certain surgical procedure codes; CPT 92941 no longer reimbursable in the outpatient setting; IHCP updates FQHC and RHC encounter codes All, ASC, FQHC, Hospital, OPR, Physician, RHC
BR201831 7/31/2018 Procedure codes assigned maximum fee pricing and linked to revenue code 636; HCPCS code J0606 linked to revenue code 636; IHCP to mass reprocess or mass adjust claims for radiology services codes that denied incorrectly; New modifiers created for use when billing 340B drugs; Prior authorization is no longer required for HCPCS code J1726; IHCP corrects CPT code 27477 description published in Banner Page BR201825; IHCP clarifies when to use Southeastrans for NEMT; DXC email addresses changing from @HPE to @DXC; Mark your calendar for the 2018 IHCP Annual Provider Seminar All, Clinic, Hospital, Pharmacy, Physician, Radiology
BR201830 7/24/2018 This banner page has been canceled.
BR201829 7/17/2018 IHCP clarifies coordination requirements with Southeastrans for facility transport scenarios; NEMT town hall presentations and FAQs available for reference; Portal enhancements allow providers to view dental, professional, and institutional claim attachments; Applied Behavioral Analysis PA Checklist updated All, Behavioral Health, Mental Health, Transportation
BR201828 7/10/2018 IHCP to cover CPT code C9492; IHCP to update pricing for CPT codes 99601 and 99602; IHCP clarifies policies regarding nonemergency medical transportation services rendered to members with retroactive eligibility; IHCP removes certain procedure codes from the renal dialysis composite rate All, APN, ESRD Clinic, Hospital, Physician, Physician Asst, Transportation
BR201827 7/3/2018 IHCP to cover CPT code 93050; IHCP to cover CPT code 65785; New program integrity audit process training now available; IHCP links additional procedure codes to specialty 140 - Podiatrist All, Podiatrist

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