IHCP Important updates posted to the website - Published 11/21

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on November 21, 2017 (unless alternate date is noted). 

Bulletins and Banner Pages 
BR201747
-Providers may resubmit certain claims for HCPCS code J3590 that may have denied incorrectly
-IHCP to accept and process replacement claims for B4157 that may have paid incorrectly 
-Providers may resubmit claims for HCPCS codes C9491 and C9493 that may have denied incorrectly
-IHCP announces IEP-related nursing services rate for calendar year 2018
-IHCP updates attachment requirements for certain procedure codes
-Taxonomy codes for rendering providers not required on claims
-IHCP implements taxonomy code requirement changes
-Update on CoreMMIS implementation issues with MRO, AMHH, BPHC, and CMHW benefit packages
-IHCP will no longer publish one of the vision services code tables on the provider website

Provider Reference Modules 
Provider and Member Utilization Review
-Reorganized and edited text as needed for clarity
-Changed Hewlett Packard Enterprise references to DXC Technology
-Updated the oversight office for program integrity in the Program Integrity section
-Added SUR Audit and Overpayment to mailing address in the Reporting, Returning, and Explaining Overpayments section
-Updated telephone number that providers use to self-report any violation of the federal exclusion policy in the Federal Exclusion from Program Participation section
-Updated the Request for Administrative Reconsideration (RAR) section: 
    Added FAF letter as an option providers might receive 
    Added paragraph to clarify what actions providers can take
-Combined the Timely Filing of Claims section into the Claim Submission section and clarified what information appears in the modules referenced in that section
-Clarified the instructions in the Claim Administrative Review and Appeals Procedures section
-Updated PERM review dates in the Payment Error Rate Measurement Audits section

Claim Administrative Review and Appeals
-Reorganized and edited text as needed for clarity
-Changed Hewlett Packard Enterprise references to DXC Technology
-Changed the web page link in the For Claims with NCCI Edits section
-Clarified in the Filing an Administrative Review Request section that the date of notification of claim payment or denial is the date on the most recent RA for the claim 

Family Planning Eligibility Program
-Reorganized and edited text as needed for clarity
-Updated the Program Coverage and Limitations section 
    Replaced specific Pap smear/cytology guidelines with reference to the Obstetrical and Gynecological Services module 
    Added reference to Laboratory Services module for HIV testing guidelines 
    Added reference to Family Planning Eligibility Program Codes for complete list of covered procedure codes
-Added Eligibility Verification heading and added specifics of how this coverage appears in the Eligibility Verification System
-Updated the Billing and Reimbursement Requirements section: 
    Updated examples of eligible IHCP-enrolled providers 
    For professional billing, changed “physicians” to “practitioners” (to encompass all applicable provider types) and added that only Family Planning Eligibility Program diagnosis codes are allowed on the claim 
    For institutional billing, added hospitals as billers and added the term principal to define primary diagnosis code
-Added an introduction paragraph under the Description of Services heading, including a reference to the new, combined table of Family Planning Eligibility Program procedure codes (and removed from the subsections references to individual code tables based on type of service) 
-Updated the Annual Examinations and Office Visits section
-Updated billing instructions in the Contraceptives section, including clarifying that NDC information is required on the claim when applicable 
-Added reimbursement information regarding insertion and removal of implants in the Contraceptive Implants section
-In the Sterilization section, added reference to the Family Planning Services module for information about the Consent for Sterilization form and related issues and incorporated information about covered anesthesia codes from the former Anesthesia for Sterilization section
-Streamlined text in the Hysteroscopic Sterilizations with an Implant Device (Essure) section (including incorporating former Table 2 into the body of the section) and added reimbursement information from the Family Planning Services module

Code Table and Other Updates
The following updated code tables are now available on the Code Sets page:
Chiropractic Services Codes – Covered Procedure Codes for Chiropractors (Specialty 150) 
    See BR201742 for details

Chiropractic Services Codes – ICD-10 Diagnosis Codes Allowed for Chiropractors (Specialty 150) 
    See BR201742 for details

Family Planning Eligibility Program Codes 
    All codes were reviewed 
     Diagnosis code tables were consolidated into a single table 
    Procedure code tables were consolidated into a single table (with correction per BT201436)

Procedure Codes That Require NDCs 
    See BR201737, BT201764, and BT201741 for details

Procedure Codes That Require Attachments 
    See BR201741, BR201713, BT201640, and BR201602 for details 
    Correction per BT200832

Podiatry Services Codes – Covered Procedure Codes for Podiatrists (Specialty 140) 
    See BR201742 and BT201694 for details

Vision Services Codes – Vision Services Code Set for Opticians (Specialty 190) 
    See BR201742 for details

Check out these resources to stay up-to-date with the most recent changes at the IHCP.