IHCP Important updates posted to the website - Published 7/31

​The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on July 31, 2018 (unless alternate date is noted). 

Bulletins and Banner Pages 
BT201839 – Physician assistants required to enroll as IHCP providers 
BT201838 – IHCP reorganizes provider relations regions to improve response time to provider inquiries 
BT201837 – IHCP revises the reimbursement policy for PRTF services provided to DCS-placed children 
BT201836 – FSSA announces CMS approval of FSW and CIH Waiver amendments 
BR201831 
• 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

Provider Reference Modules 
Dental Services (See the module for a complete listing of changes) 
• Clarified information in the Prior Authorization for Dental Services section and updated references to the IHCP Prior Authorization Dental Request Form 
• Updated the Dentures – Complete and Partial section and its subsections 
• Clarified billing information and updated the heading for the Palliative Treatment of Facial Pain for Emergency Dental Services section 
• Added coverage information to the Extractions section 
• Updated the Fluoride Treatment (Topical) section and its subsection 
• Added the Frenulectomy (Frenectomy or Frenotomy) section 
• Added the Maxillofacial Surgery section 
• Added a table for coverage limitations in the Oral Evaluations, Periodontal Maintenance, Periodontal Root Planing and Scaling and Full-Mouth Debridement, Prophylaxis, and Radiographs sections 
• Completely updated the Orthodontics section and its subsections to reflect current policies and procedures 
• Added the Periodontal Surgery section 
• Updated the Restorations section and subsections 
• Updated the Sedation for Dental Procedures (Dental Anesthesia) section 
• Updated and renamed the Services Provided Outside the Dental Office section, and consolidated information from the former Billing for Dental Procedures at a Hospital or ASC section 
• Added information to the Space Maintenance section 
 
Outpatient Facility Services 
• Changed the module name from Outpatient Hospital and Ambulatory Surgical Center Services and revised terminology throughout to “outpatient facility services” 
• Added information about nonpatient services to the Introduction section 
• Removed the specific HAF factor from the Rate Reduction section 
• Added EOB numbers and descriptions to the Outpatient Service within 3 Days before an Inpatient Stay section 
• Clarified that some implantable devices are separately reimbursable for outpatient surgery in the Outpatient Surgeries section 
• Replaced Table 1 – Revenue Codes for Treatment Room Services, Table 2 – Revenue Codes for Add-On Services, and Table 3 – Revenue Codes for Stand-Alone Services with references to Revenue Codes on the Code Sets page 
• Added information about separately reimbursable drugs (with revenue code 636) in the Treatment Room Visits section 
• In the Stand Alone Chemotherapy and Radiation Services section, updated treatment room revenue code 483 references to include all 48X revenue codes

Code Table and Other Updates
The following updated code tables are now available on the Code Sets page:
Dental Services Codes 
• All codes were reviewed 
• Dental Codes with Age Restrictions table was removed (information is now available on the Professional Fee Schedule)

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

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