IHCP Update: Published June 10

The Indiana Health Coverage Programs posted the following important information to the provider website at in.gov/medicaid/providers on June 10, 2021 (unless alternate date is noted).

​Bulletin
BT202143 – IHCP clarifies physical medical care requirements for behavioral health professionals

Provider Reference Modules
Podiatry Services

• In the Office Visits section:
• Updated the limit for podiatry office visits from “per 12 months” to “per calendar year” and updated the description for the related system audit (6090)
• Removed CPT code 99201
• In the Routine Foot Care section, updated the limit for routine foot care from “per 12-month period” to “per calendar year”
• In the Surgical Services section, clarified language about confirmatory consultations to align with 405 IAC 5‑26‑10
• In the Laboratory and X-Ray Services section, added information about laboratory services reimbursed for podiatrists

Surgical Services

• Added policy indicators for modifier 51 in the Multiple Procedures section
• In the Facility Billing and Reimbursement for Outpatient Surgeries section, removed the 9xx revenue codes from the list of treatment codes that can also be surgical codes
• Clarified the definition of “multiple surgeries” in the Multiple Surgeries and Bilateral Procedures section
• Updated the Temporomandibular Joint (TMJ) Syndrome section to include additional behavioral health practitioners that can provide psychological therapy and to clarify PA requirements for surgical treatment for TMJ syndrome
• Added information in the Transplant Procedures section about the IHCP following UNOS guidelines for organ transplant criteria and updated the applicable subsections accordingly
• Added the Fecal Microbiota Transplant section
• Added the Auditory Brainstem Implants section
• Added introductory text in the Arthroplasty (Artificial Disc) section, updated the Lumbar Arthroplasty section and added subsections for Upper-Spine (Cervical) Arthroplasty and Second-Level Cervical Arthroplasty
• Added the Spinal Stenosis Devices section
• Clarified ICD diagnosis requirements for PA requests in the Vagus Nerve Stimulator section
• Updated Table 12 – Reimbursement for Devices When Implanted in an Outpatient Setting

Code Tables
The following code table updates are accessible from the Code Sets page:
Podiatry Services Codes

• All codes were reviewed

Surgical Services Codes

• All codes were reviewed

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