Update on Billing Issues 3/29/2017

INARF has learned that issues related to billing for Wellness Coordination on the CIH Waiver should soon be resolved, please see the attached bulletin for more information.

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The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on March 28, 2017 (unless alternate date is noted).

News and Announcements (home page) 
    OPR Search Tool now available

Bulletins and Banner Pages 
BT201723 - IHCP revises coverage policies for home health services
BR201713
IHCP to cover HCPCS code Q5102
IHCP will no longer cover chemistry and toxicology tests
IHCP will no longer cover HCPCS code S3000
OPR Search Tool now available
IHCP revises maximum facility reimbursement rates for birthing centers
Pricing updated for HCPCS codes A6450 and A6451
Prior authorization is now required for CPT code 69930
Providers should no longer bill certain DME procedure codes with the NU modifier
Pricing updated for CDT codes D0251 and D1354
IHCP updates attachment requirements for various HCPCS codes

Provider Modules
Presumptive Eligibility
Portal process updated where applicable
Portal snaps updated where applicable
Changed Web interChange to Provider Healthcare Portal
Changed IndianaAIM to CoreMMIS
Replaced RID with Member ID
Changed Automated Voice Response (AVR) system to Interactive Voice Response (IVR)

Hospital Presumptive Eligibility
Changed Web interChange to the Provider Healthcare Portal
Changed IndianaAIM to CoreMMIS
Changed Automated Voice Response (AVR) system to Interactive Voice Response (IVR) and updated phone number
Changed RID to Member ID
Portal process updated, where applicable
Portal snaps populated, where applicable
Moved Member Identification and Admission Date sections under new Presumptive Eligibility Period heading.

Hearing Services
Changed hearing aid specialist references to hearing aid dealer
Added the Provider Healthcare Portal option to billing and PA instructions
Removed clinical fellowship year audiologist from the list of providers that must conduct audiological assessments in the Hearing Services Coverage and Prior Authorization Requirements section

Home Health Services
Updated billing and PA instructions to include Provider Healthcare Portal options
Replaced references to IndianaAIM with CoreMMIS
Clarified the use of 99600 TD in Home Health Nursing PA Request Coding
Updated billing information regarding occurrence codes in the PA Exception for Hospital Discharge, Overhead Rate, and Home Health Reimbursement sections
Added notes to Table 1 - Revenue Codes Crosswalked to Procedure Codes for Home Health Services and Table 3 - Codes for Billing Initial Evaluations for Physical, Occupational, and Speech Therapy in Home Settings to indicate code changes that took place after this module's effective date
Removed outdated home health agency rate-setting methodology from the Home Health Reimbursement section
Updated the Customer Assistance telephone number
Updated the CMCS mailing address

Injections, Vaccines, and Other Physician-Administered Drugs
Added Provider Healthcare Portal instructions for billing
Removed ICD-9 information
Updated Customer Assistance and TPL Unit telephone numbers
Updated information in the Remittance Advice and NDC-Related Explanations of Benefits section

Vision Services
Replaced Automated Voice Response (AVR) system references with Interactive Voice Response (IVR) system
Replaced Web interChange references with Provider Healthcare Portal
Updated claim references to reflect Portal billing options
Updated the Written Correspondence section to include information about submitting coverage inquiries through the Portal and revised time frame for response 

Family Planning Eligibility Program
Changed Automated Voice Response (AVR) system reference to Interactive Voice Response (IVR) system and updated the telephone number for the IVR system
Changed Web interChange reference to Provider Healthcare Portal
Removed ICD-9 codes
Updated billing information with Portal options throughout the module
Updated the EOB information in Table 1 − EOBs Applicable to the Family Planning Eligibility Program
Updated Table 2 - Family Planning Eligibility Program − Billing Instructions for the Hysteroscopic Sterilization Procedure with Implant Device

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