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The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on July 10, 2018 (unless alternate date is noted). News and Announcements (home page) • NEMT town hall presentations and FAQs available for reference Bulletins and Banner Pages BT201834 – IHCP clarifies nonemergency medical transportation policy for dually eligible members BR201828 • 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 Provider Reference Modules
Long-Term Care (For a complete list of changes, see the module.) • Added contact information for accessing the web-based PASRR system to the Level-of-Care Screens, Level I Screens, and Level II Evaluations for Long Term Care section • Added information about who conducts the LOC screen to the Level-of-Care Screen section • Clarified which applicants and residents are required to undergo the LOC screen in the Level-of-Care Screen Requirements section • Added a statement about appeals to the Level-of-Care Outcome and Level II Outcomes sections • Updated information regarding APS reports in the Provisional Emergency Situations section • Updated information in the Level II Referral Process section • Updated the LOC Referral Process section, including due date, mailing instructions, and addressee for the LOC referral form • Added the Nursing Facility Requirements for HIP Members section • Clarified requirements in the Short-Term Placement in a Nursing or LTC Facility section around eligibility verification and MCE notification • In the Nursing Facility Reimbursement section, updated end date for the 3% reduction in NF reimbursement • Updated items under the direct care, indirect care, administrative, and capital components in the Case-Mix Reimbursement section • Updated the Member Liability section to include information about veterans’ pensions Provider and Member Utilization Review • Updated the mailing address in the Reporting Fraud and Abuse section • In the Reporting, Returning, and Explaining Overpayments section, noted that, for overpayments involving a small number of claims, the Portal process for adjusting claims is preferred • Updated the mailing address for administrative review requests in the Claim Administrative Review section • Updated contact information in the Communications with Prepayment Review section • Added a web page reference in the Payment Error Rate Measurement Audits section • Updated the mailing and email addresses in the PERM Contact Information section • Updated the contact information in the Indiana RAC Contact Information section Division of Mental Health and Addiction Child Mental Health Wraparound Services (For a complete list of changes, see the module.) • Updated references in Table 1 – Child Mental Health Wraparound Program • Added the Wraparound Fidelity Index Short Version WFI EZ section • Updated Access Site responsibilities in the High Fidelity Wraparound Access Site Responsibilities and Expectations section • Updated the Target Group Criteria section • Added a freedom of choice right in the Applicant Evaluation section • Updated the Submission of the CMHW Application section • Updated the Participant Termination, Interrupt, and Re-Start Status section • Updated the Participant Transition from CMHW Services section • Completely updated Section 11: Critical Events and Incident Reporting • Updated Section 12: Participant Complaints and Grievances • Clarified information about the child abuse registry screen in the General Provider Requirements section • Updated the Qualifying SED Experience Requirements section • Updated the Application Process section and subsections • Updated standards and requirements in the Documentation of Supervision section • Updated documentation requirements in the Content Standards for Service Notes section • Updated the Quality Assurance Review section • Updated the Quality Improvement Strategic Planning Process section Code Table and Other Updates The following updated code tables are now available on the Code Sets page: • Long-Term Care Codes o All codes tables reviewed • Procedure Code Modifiers for Professional Claims o See BT201832 for details • Procedure Codes That Require NDCs o See BT201832 for details • Revenue Codes Linked to Specific Procedure Codes – Procedure Codes Linked to Revenue Code 636: Drugs Requiring Detailed Coding o See BT201832 for details The following new code table is now available on the Code Sets page: • Physician-Administered Drugs Carved Out of Managed Care and Reimbursable Outside the Inpatient Diagnosis-Related Group o See BT201812, BT201832, and BR201818 for details Check out these resources to stay up-to-date with the most recent changes at the IHCP. Comments are closed.
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