IHCP Updates - Published 10/1

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on October 1, 2019 (unless alternate date is noted).

Bulletins and Banner Page
BT201958 – Pharmacy update approved by Drug Utilization Review Board September 2019
BT201957 – DXC assumes fee-for-service Medicaid prior authorization and utilization management services
BR201940

• IHCP announces IEP-related nursing services rate for calendar year 2020
• IHCP adds procedure codes 73700 and Q4038 to the Podiatry Services Code Set

​Provider Reference Module
Inpatient Hospital Services (see the module for a complete list of updates)

• Updated the Prior Authorization for Hospital Inpatient Admissions section
• Added the Inpatient Admission Criteria section and subsections
• Added information in the Inpatient Level-of-Care Reimbursement System section about the number of days reimbursed under LOC
• Removed St. Joseph’s Hospital of Ft. Wayne from the Burn/1 facility list in the Level-of-Care Payment Rates section
• Updated the address in the Qualification for Medical Education Payments section
• Added the Change in Coverage during Inpatient Stay section
• Added the Reimbursement for Promoting Interoperability Program section
• Updated the Long-Term Acute Care Hospital Services section and added the following subsections: Admission Criteria, Continued Stay Criteria, and Discharge Criteria
• In the Transfers section, added a note regarding retrospective review for facility transfers
• Clarified information in the Readmissions section

Code Table
The following code table updates are accessible from the Code Sets page:
Inpatient Hospital Services Codes

• All codes were reviewed
• Removed the four birthweight diagnosis code tables
• Updated the ICD-10 Deep Vein Thrombosis and Pulmonary Embolism Diagnosis Codes Excluded from Hospital-Acquired Condition (HAC) and Present on Admission (POA) Requirements for Pediatric or Obstetric Patients table:

• See BR201955 for details

• Added a note to the Procedure Codes Payable as an Inpatient Service When Delivered in an Inpatient Setting for Stays of Less Than 24 Hours table:

• See BR201825 for details

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