IHCP Updates - Published 4/9

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on April 9, 2019 (unless alternate date is noted).

​News and Announcements (home page)
IHCP announces live webinar for diabetes self-management training providers (April 5, 2019)
​

Bulletins and Banner Page
BT201921 – IHCP updates tobacco cessation drug treatment coverage
BT201920 – FSSA announces new member eligibility system
BR201915

• IHCP to correct vision code sets, and reprocess or adjust vision services claims that denied incorrectly
• IHCP reminds providers of revised billing for ABA therapy services, and of codes to be end dated June 30, 2019
• IHCP clarifies revenue code linkages to procedure codes for billing transcranial magnetic stimulation services
• IHCP clarifies coverage for Hoosier Healthwise members during retroactive eligibility period
• IHCP reminds providers of new administrative code requirement for documenting medical records

​
Provider Reference Modules
Vision Services (See module for full listing of changes)

• Updated the Eye Examinations section
• Clarified reimbursement criteria in the Eyeglasses section
• Updated the Repair or Replacement of Eyeglasses section
• Updated the Orthoptic or Pleoptic Training, Vision Training, and Therapies section
• Added the Ophthalmologic Surgeries heading and introductory text, and updated the subsections as follows:
  • Replaced information in the Corneal Tissue subsection with a cross-reference to the Surgical Services module
  • Added the Vitrectomy subsection
• Added the Physician-Administered Ophthalmological Drugs heading and introductory text, and updated the subsections as follows:
  • Added the Voretigene Neparvovec-rzyl (Luxturna) subsection
  • Added J3300 as a drug that could be billed for ophthalmological use and added NDC requirements in the Triamcinolone Acetonide subsection
• Added PA requirements in the Fluocinolone Acetonide Intravitreal Implant (Retisert) subsection

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

Physician-Administered Drugs Carved Out of Managed Care and Reimbursable Outside the Inpatient Diagnosis-Related Group

• See BT201919 for details

Procedure Codes That Require National Drug Codes (NDCs)

• See BT201919 for details

Revenue Codes with Special Procedure Code Linkages

• Updated the following tables:
  • Procedure Codes Linked to Revenue Code 920 – Other Diagnostic Services – General
  • Procedure Codes Linked to Revenue Code 940 – Other Therapeutic Services – General
• See BT201909 and BR201915 for details

Vision Services Codes

• All codes were reviewed
• Updated the following tables:
  • Covered Procedure Codes for Opticians (Specialty 190)
  • Covered Procedure Codes for Optometrists (Specialty 180)
• See BR201915 for details

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