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The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on September 6, 2018 (unless alternate date is noted). News and Announcements (home page) • IHCP delays Portal enhancement for converting OPR and rendering provider classifications (September 7, 2018) Provider Reference Modules
Claim Submission and Processing (see the module for a full list of changes) • Updated the information throughout the module regarding the IHCP TPL/Medicare Special Attachment Form • Updated form information and the link for accessing pharmacy forms in the Paper Claim Forms section • Updated requirements for professional and institutional paper claim forms in the Ordering Claim Forms section • Updated the paper claim billing processes in the Paper Claim Submission Guidelines section • In the ICD Codes section, clarified which claims require a diagnosis code • Added the Add-On Codes section • Defined place of service codes in the Place of Service Codes section • In the Revenue Code 513 – Psychiatric Clinic section, updated billing guidelines for revenue code 513 • Updated Table 4 – UB-04 Claim Form Fields • Updated Figure 1 – UB-04 Claim Form with a red claim form • Updated Table 5 – Types of Services Billed on Professional Claims, including adding provider types 35 – Addiction Services and 10 – Physician Assistant • Added NPI placement instructions on the different claims in the Provider Classifications – Billing, Group, Rendering, and OPR section • Updated the Documenting Denied or Zero-Paid Claims section • In Table 17 – Claims Returned to Provider, updated the explanation of what is needed for a Medicare HMO Replacement Plan paper claim • Updated the note box regarding billing in the Claims That Do Not Cross Over Automatically section Code Table and Other Updates All codes were reviewed on the following updated code tables, now available on the Code Sets page: Procedure Code Modifiers for Professional Claims Procedure Codes That Require Attachments • See BT201826 for details Procedure Codes That Require National Drug Codes (NDCs) Revenue Codes Revenue Codes with Special Procedure Code Linkages (previously Revenue Codes Linked to Specific Procedure Codes) Medical Review Team Codes Check out these resources to stay up-to-date with the most recent changes at the IHCP. Comments are closed.
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