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IHCP Update: Published 7/28

7/29/2020

 
The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on July 28, 2020 (unless alternate date is noted).
​Banner Page
BR202030
  • IHCP updates personal care services procedure codes that require EVV

Provider Reference Modules

Anesthesia Services
  • Updated the Anesthesia Procedure Codes and Modifiers section to remove the AA modifier requirement
  • Updated the Anesthesiologist Assistant Requirements section and added a footnote clarifying the usage of the QX modifier
  • Updated the Medical Direction Requirements section, including:
  • Added information about claims denying if multiple providers bill the same anesthesia service code for the same member on the same date, unless the appropriate medical direction modifier is used
  • Clarified that claim details billed with the QY modifier will deny
Hospice Services (see the module for a complete list of updates)
  • Changed CMCS references to DXC and updated contact information where applicable
  • Updated the Hospice Core and Noncore Services section to provide clarification around nonhospice versus hospice physician services
  • Updated the Hospice Providers Located Outside Indiana section
  • Added a note about the removal of hospital lock-in requirements in the Right Choices Program (Lock-In) Members section
  • Added Emergency Services Only Coverage with Pregnancy Coverage (Package B) to the list in the Programs and Aid Categories Ineligible for the IHCP Hospice Benefit section
  • Updated Table 5 – Indiana Health Coverage Programs Prior Authorization Request Form Fields for Hospice Requests
  • Clarified information and updated the timely filing limit in the Special Batch Claims section
  • Clarified information about hospice per diem rates in the introductory text for Section 6: Billing and Reimbursement and added a note about where to find the current rates
  • Added a note in the Revenue Codes section to clarify usage of revenue codes 651 and 652
  • Updated the Admission to a Nursing Facility for Treatment of Nonterminal Conditions section and Scenario 1 subsection to include cases where the member is admitted directly to a nursing facility for recovery from a nonterminal condition, without first being hospitalized

Code Tables

The following code table updates are accessible from the Code Sets page:
Anesthesia Services
  • All codes were reviewed
Hospice Services Codes
  • All codes were reviewed
Service Codes That Require Electronic Visit Verification
  • Updated the following table: Procedure Codes and Modifiers for Personal Care Services That Require EVV
  • For details, see BR202029 and BR202030

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

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