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IHCP Important updates posted to the website - Published 8/1

8/4/2017

 
The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on August 1, 2017 (unless alternate date is noted). 

News and Announcements (home page) 
IHCP temporarily delays implementation of new Addictions Services/OTP provider type and specialty
Bulletins and Banner Pages 
BT201752 – IHCP revises FFS pharmacy claims and PA processes related to diabetes supplies
and holding chambers for inhaled medications
BT201751 – Pharmacy update approved by Drug Utilization Review Board July 2017
BR201731 
-IHCP to cover HCPCS code S0073- Aztreonam, injection, 500 mg 
-IHCP to mass-adjust or mass-reprocess claims for crisis intervention services 
-IHCP providers experiencing delays with provider enrollment transactions 
-IHCP extends deadline to update rendering provider linkages for proper claim adjudication to January 1, 2018 
-Providers may resubmit claims that denied inappropriately for EOB 2504

Provider Reference Modules 
Chiropractor Services 
-Edited and reorganized text throughout the module for clarity 
-Added self-referral information in the Introduction section 
-Clarified information in the Laboratory Services Provided by a Chiropractor section and its subsections 
-Updated information in the Diagnosis Codes for Chiropractor Billing section 
-Dental Services 
-Edited and reorganized information as needed for clarity 
-Changed HPE and Hewlett Packard Enterprise to DXC 
-Updated Hoosier Healthwise information in the Dental Services for Managed Care Members section 
-Added Portal in billing instructions in the Billing for Dental Procedures at a Hospital or ASC section 
-Updated the following in the Member Eligibility Verification and Benefit Limit Information section:
    - Added 270/271 electronic transaction to EVS options and provided Portal link and IVR telephone number 
    - Clarified that EVS benefit limit information is for FFS members only and removed specific limits listed 
    - Added additional EOBs to Table 1

-Updated the Prior Authorization for Dental Services section 
-Clarified prior authorization requirements in the Dentures and Partials section 
-Changed acrylic to resin partial dentures in the Covered Partial Denture Types section 
-Added note about HIP to the Periodontal Maintenance section 
-Clarified information in the Radiographs section and added D0240 
-Added the Space Maintainers section 
-Updated the Topical Fluoride Treatment section

Obstetrical and Gynecological Services 
-Edited and reorganized text for clarity 
-Removed ICD-9 codes 
-Updated guidelines in the Cervical Cancer Screenings section 
-Added references to Prenatal and Preventive Pediatric Care Diagnosis Codes That Bypass Cost Avoidance in the Billing for Pregnancy-Related Services section
-Added reference to Obstetrical and Gynecological Services Codes in the Echography section 
-Updated the High-Risk Pregnancy section 
-Removed the Coverage Criteria for 17P and Makena Injections section 
-Updated the Multiple Births section to remove postpartum care and added procedure code 59620 
-Added the Reimbursement for Long-Acting Reversible Contraception Implanted During Delivery Stays section 
-Updated Figure 1 – Example of Acknowledgement of Receipt of Hysterectomy Information 

Therapy Services
-Edited and reorganized text as needed for clarity 
-Updated references in the Introduction section 
-Removed exemptions for physical therapy and occupational therapy services from the Prior Authorization for Therapy Services section 
-Updated information about rehabilitative and habilitative services and added note about HIP limitations in the Coverage and Limitations for Therapy Services section 
-Updated the following in the Occupational Therapy Services section: 
   - expanded provider types that can order occupational therapy 
   - Changed “licensed” and “certified” to “registered” to reflect change in IHCP policy 
   - Removed PA exemption for acute medical condition provided in an outpatient setting

-Updated the following in the Physical Therapy Services section: 
   - Expanded provider types that can order physical therapy 
   - Removed PA exemption for acute medical condition provided in an outpatient setting

-Clarified information about PTAs in the Physical Therapy Services section and the Covered Procedures for Physical Therapist Assistants subsection 
-Modified 97530, 97533, and S8940 code descriptions in the Hippotherapy section 
-Updated the Respiratory Therapy Services section 
-Added the Speech Pathology section 
-Added electronic billing options in the Comprehensive Outpatient Rehabilitation Facilities section

Code Table and Other Updates
The following updated code tables are now available on the Code Sets page:
Chiropractic Services Codes 
    - Reviewed all tables 
    - Subdivided the Covered Procedure Codes for Chiropractors (Specialty 150) code set by type of service

Dental Services Codes 
    - Reviewed all tables 
    - Added the Dental Codes That Require a Tooth Number on the Claim table (see BR201725) 
    - Removed the Covered Dental Procedure Codes for Partial Dentures table (see the Dental Services module for relevant codes) 
    - Updated the Dental Codes with Age Restrictions table (see BT201694) 

Obstetrical and Gynecological Services Codes 
    - Reviewed all tables 
    - Added the Long-Acting Reversible Contraception (LARC) Devices Separately Reimbursable During an Inpatient Hospital or Birthing Center Stay for Delivery table (Table will be removed from the Family Planning Services Codes document) 
    - Removed ICD-9 code tables

Therapy Services Codes 
    - Reviewed all codes

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

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