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CareSourceMedicaid · Billing Codes · Provider Bulletin · IN · Physical Therapy, Wound Care, General Surgery +1 moreMedium impact

[Indiana] Lymphedema Compression Treatment Items Claims Editing Enhancements

Act
by May 4, 2026
Effective date
May 4, 2026
Identified
May 9, 2026

Summary

CareSource is implementing enhanced claims editing for lymphedema compression treatment items (HCPCS codes A6520-A6610) effective May 4, 2026. Billing teams must ensure appropriate lymphedema diagnosis codes are used and apply right side (RT) or left side (LT) modifiers for bilateral claims, as the payer will now enforce stricter validation on these claims.

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What to do

by May 4, 2026 · 7 steps
01Billing team must implement the following updates.
02Ensure all claims for lymphedema compression treatment codes (A6520-A6530, A6533-A6541, A6549, A6552-A6589, A6593-A6610) include appropriate lymphedema diagnosis codes.
03Update billing system to require and automatically apply RT (right side) or LT (left side) modifiers for all lymphedema compression claims to indicate treatment laterality.
04Review current billing templates and encounter forms to prompt providers for correct diagnosis coding and laterality documentation.
05Train billing staff on the new requirements.
06Failure to include proper diagnosis codes and laterality modifiers will result in claim denials from CareSource.
07Contact CareSource Health Partner Services at 1-833-230-2101 (Marketplace) or 1-844-607-2831 (Medicaid) with questions.

Codes mentioned

A6520A6521A6522A6523A6524A6525A6526A6527A6528A6529A6530A6533A6534A6535A6536A6537A6538A6539A6540A6541A6549A6552A6553A6554A6555A6556A6557A6558A6559A6560A6561A6562A6563A6564A6565A6566A6567A6568A6569A6570A6571A6572A6573A6574A6575A6576A6577A6578A6579A6580A6581A6582A6583A6584A6585A6586A6587A6588A6589A6593A6594A6595A6596A6597A6598A6599A6600A6601A6602A6603A6604A6605A6606A6607A6608A6609A6610

Original notice

[Indiana] Lymphedema Compression Treatment Items Claims Editing Enhancements
caresource.com · Always check the source before changing claims.
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Related changes

See all CareSource changes →
[Ohio] Lymphedema Compression Treatment Items Claims Editing EnhancementsMediumEffective Jan 15, 2026 · Provider Bulletin[Georgia] Lymphedema Compression Treatment Items Claims Editing EnhancementsMediumEffective Feb 24, 2026 · Provider Bulletin[Ohio] Prior Authorization Requirement UpdateHighEffective Apr 1, 2025 · Provider Bulletin[Georgia] Prior Authorization Requirement UpdateMediumEffective Apr 1, 2025 · Provider BulletinBrowse every CareSource change in the policy list

Related policy hubs

CareSource policiesIN policy changesPhysical TherapyWound CareGeneral SurgeryOncologyCode A6520Code A6521Code A6522Code A6523Code A6524Code A6525Code A6526Code A6527Code A6528Code A6529Code A6530Code A6533Code A6534Code A6535Code A6536Code A6537Code A6538Code A6539Code A6540Code A6541Code A6549Code A6552Code A6553Code A6554Code A6555Code A6556Code A6557Code A6558Code A6559Code A6560Code A6561Code A6562Code A6563Code A6564Code A6565Code A6566Code A6567Code A6568Code A6569Code A6570Code A6571Code A6572Code A6573Code A6574Code A6575Code A6576Code A6577Code A6578Code A6579Code A6580Code A6581Code A6582Code A6583Code A6584Code A6585Code A6586Code A6587Code A6588Code A6589Code A6593Code A6594Code A6595Code A6596Code A6597Code A6598Code A6599Code A6600Code A6601Code A6602Code A6603Code A6604Code A6605Code A6606Code A6607Code A6608Code A6609Code A6610

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