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The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on December 12, 2017 (unless alternate date is noted). Bulletins and Banner Pages BR201750 -IHCP to mass adjust or mass reprocess claims for prenatal services that may have adjudicated incorrectly due to visit limitation audits -Save the date for the 2018 Spring IHCP Provider Workshops Provider Reference Modules
Claim Adjustments -Added Voids and Replacements as a subtitle to module name -Edited and reorganized text as needed for clarity -Replaced Hewlett Packard Enterprise references with DXC Technology -Added ICN as alternate terminology for Claim ID -Revised language throughout the module to reflect that void and replacement terminology is not specific to electronic adjustments -Updated the Introduction section with definitions of void and replacement -Updated the Types of Adjustments section as follows: - Incorporated mass replacements for LTC facility rate adjustments as a type of mass adjustment - Added mass replacements for end-of-month waiver liability as a type of mass adjustment - Added a category for adjustments converted from the previous MMIS - Added a general explanation of region codes -Added region code 57 to the Check-Related Voids and Replacements section and defined region code 51 -Added region codes 56, 61, 62, and 63 to the Non-Check-Related Voids and Replacements section and defined region code 50 -Added region codes 55, 56, and 64 to the Mass Voids or Replacements section and defined region code 52 -Added End-of-Month Adjustments for Waiver Liability as a subsection under Mass Voids or Replacements -Added the Adjustments Converted from the Previous System section -Expanded information in the note box about submitting detail-level TPL information in the Adjustment Submission Procedures section -Added procedures for tracking electronic adjustments in the Claim Adjustment Processing and Tracking section Financial Transactions and Remittance Advice -Edited and reorganized text as needed for clarity -Replaced Hewlett Packard Enterprise references with DXC Technology -Made updates to Table 1, including the following: - Moved RA subheads to the third column - Updated descriptions for fields 10, 11, 24, 35, 40, 70, 71, and 79 -Swapped fields 70 and 71 (and made corresponding updates to Figures 2–6 and 8–11) -Removed ARC 178 from Table 3 -Corrected callouts in Figures 2, 7, 10, and 11 in the Remittance Advice Examples section -Removed the reference to transfer letter in step 4 in the Recovery of Accounts Receivable section -Specified in the Accounts Receivable Referrals section that the transfer letter is sent to the pay-to address -Updated Figures 20 and 21 in the Accounts Receivable Referrals section -Updated Figure 22 in the Partial Payments and Repayment Agreements section -Updated the How to Enroll in the IHCP Electronic Funds Transfer Option section -Reorganized and clarified text in the How to Cancel EFT Participation or Change EFT Information section -Specified in the B-Notice Process section that documents are sent to the home office (legal) address National Correct Coding Initiative -Edited text as needed for clarity -Replaced the reference to Medicaid NCCI Edit Design Manual in the Use of Modifiers section with Medicaid NCCI Technical Guidance Manual -Removed time limitations from the NCCI Editing of Claims Submitted via the Provider Healthcare Portal section -Updated the description for EOB 4183 in Table 1 – EOB Codes Related to NCCI Code Editing -Added the Ground Transportation Mileage section Anesthesia Services -Reorganized and edited text as needed -Clarified usage of modifier 50 in the Anesthesia Procedure Codes and Modifiers section -Added Portal and 837P to instructions in the Time Units section -Added introductory text and anesthesiology assistant information to the Medical Direction and CRNA and AA Billing and Reimbursement section, organized the remaining text into separate subsections, and incorporated Table 2 information into the text -Clarified billing information in the Regional Anesthesia (Epidural and Spinal Neuraxial Blocks) section Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)/HealthWatch -Edited text as needed for clarity -Replaced the EPSDT/HealthWatch Periodicity and Screening Schedule and references with references to the Bright Futures/American Academy of Pediatrics (AAP) Recommendations for Preventive Pediatric Health Care periodicity schedule -Added reference to CareSource in the Managed Care Members section -Updated the Required Components of EPSDT/ HealthWatch section per the Bright Futures/AAP periodicity schedule -Updated the instructions for finding a referral specialist in the Diagnostic and Follow-Up Services section -Removed ICD-9 codes from the EPSDT/HealthWatch Billing Procedures section -Updated where to send Hoosier Healthwise members’ names in the Missed Appointment Procedures section -Removed unneeded information from the Reimbursement for EPSDT/HealthWatch Services section -Added weight for length and age to start BMI measurements to the Measurements section -Updated the First Steps contact information in the Children Younger Than 5 Years Old section -Removed the Adolescent Maturation section -Added the Maternal Depression Screening section -Updated the unit limit and examples of screening tools in the Structured Developmental Screening section -Added the Autism Spectrum Disorder Screening section -Added the Depression Screening section -Added information about conducting a verbal assessment to the Tobacco, Alcohol, or Drug Use Assessment section -Replaced the Testing Procedures table with a reference to an online AAP publication in the Vision Testing section -Added information from the Inpatient Hospital Services module to the Newborn Hearing Screening section; also updated contact information -Updated Table 5 – IHCP Periodicity Schedule for EPSDT/HealthWatch Hearing Observation and Screening -Updated the Newborn Screening section: - Updated contact information for the Genomics and Newborn Screening Program - Updated billing and reimbursement information -Removed the reference to a code table document in the Immunizations section -Updated the screening guidelines in the Blood Lead Screening section -Updated the information in the Procedures for Sending Blood Samples for Lead Testing section -Added the Dyslipidemia Screening section -Added testing guideline in the HIV Testing section -Added reimbursement information for physician-administered topical fluoride varnish in Section 7: Dental Observation and Screening -Updated information in the Required Dental Referral section -Updated helpline information in the Dental Health Education for Parents section -Updated information on ordering resources in the Education Regarding Lead Poisoning for Pregnant Women and Children 6 Years Old or Younger section -Updated the telephone number for First Steps in the Indiana’s First Steps Program section -Updated contact information in the Indiana State Department of Health section Hearing Services -Reorganized and edited as needed for clarity -Added the Audiologists and Hearing Aid Dealers heading and updated the section -Renamed the Audiological Assessments/Hearing Tests section, added subheadings, and updated text in the section and subsections -Added the Hearing Aid Purchase heading and updated the section -Updated the Hearing Aid Replacement section -Added the Cochlear Implants section and subsections Radiology Services -Edited and reorganized text as needed for clarity -Added Portal billing options -Updated information in the Low Osmolar Contrast Materials section -Updated Fee Schedule references in the PET Scans section Code Table and Other Updates The following updated code tables are now available on the Code Sets page: Anesthesia Services Codes -All codes were reviewed -Updated the Procedure Code Set for Certified Registered Nurse Anesthetists (CRNAs) (Specialty 094) table - See BT201588 for details EPSDT/HealthWatch Services Codes -All codes were reviewed Hearing Services Codes -All codes were reviewed -Updated the Hearing Services Code Set for Audiologists (Specialty 200) table - See BR201735 and BR201742 for details -Updated the Hearing Services Code Set for Hearing Aid Dealers (Specialty 220) table - See BR201735 for details Check out these resources to stay up-to-date with the most recent changes at the IHCP. 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