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Banner # Date Topics Type
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 Dentist, Hospital, Physician
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
BR201826 6/26/2018 IHCP to cover CPT code 0398T; ASC pricing indicator assigned to CPT code 27447; New skin substitute HCPCS codes linked to revenue code 636; CPT codes 77425, 80500, and 80502 assigned maximum fee pricing; IHCP enforces restrictions on dental services through new system audits; Claim number required for claim administrative review requests and claim appeals All, Ambulatory Surgical Center, Hospital, Physician, Dental
BR201825 6/19/2018 IHCP to cover CPT code 22857; IHCP to require NDCs on claims for low osmolar contrast material; IHCP to cover home INR monitoring codes; IHCP adds coverage of fenestrated endovascular repair procedures for aortic aneurysms; IHCP reminds providers of policy alignment with Medicare for inpatient-only codes; Certain procedure codes no longer considered inpatient-only; ASC pricing indicators assigned to CPT codes 27477 and 27485; PRTF PA request attachments via the Portal All, Ambulatory Surgical Center, Hospital, Physician
BR201824 6/12/2018 IHCP enhances the Portal with NEMT eligibility information; IHCP corrects information about linking rendering providers to multiple group service locations in a single Portal transaction All, Transportation
BR201823 6/5/2018 IHCP identifies system issues with processing outpatient claims for certain revenue codes Ambulatory Surgical Center, Clinic, Hospital
BR201822 5/29/2018 IHCP to mass adjust or mass reprocess certain institutional claims that denied incorrectly for revenue code-to-procedure code combinations; IHCP to apply CMS billing guidelines for professional claims with certain surgical modifiers; Transition to single Customer Assistance telephone number to be finalized; IHCP enhances IHCP fee schedule references on the provider website All, Anesthesiologist, Advanced Practice Nurse, Hospital, Physician, Physician Assistant
BR201821 5/22/2018 IHCP issues guidance for billing and rebilling inpatient rehabilitation encounters; IHCP to include level of need information for the MRO benefit on the Portal; IHCP Portal to allow rendering provider linkages to multiple group service locations in a single transaction; IHCP to hold dental listening sessions at locations around the state in June; Sign up now for Summer 2018 IHCP provider workshops All, Community Mental Health Center, Dentist, Rehabilitation Facility
BR201820 5/15/2018 IHCP reminds providers of service location address requirements for professional and institutional claims All
BR201819 5/8/2018 HCPCS code J7340 linked to revenue code 636; IHCP to mass reprocess MRO claims for maternity members that denied inappropriately; IHCP to update pricing for HCPCS code J7178; IHCP clarifies billing guidance for blood factor HCPCS codes; IHCP reminds providers of W-9 requirements for provider enrollment transactions All, Ambulatory Surgical Center, Clinic, Home Health Agency, Hospital, Nursing Facility

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