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Hospital Monthly Important Message - 12.12.2019 pdf

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid is implementing multiple significant changes effective January 1, 2020, including updated HCPCS codes for compliance, new DRG weights and grouper systems, and mandatory use of Medicare Beneficiary Identifier (MBI) instead of HICN for Medicare billing starting January 1, 2020.

Action Required

Action needed
By January 1, 2020: Billing team must update systems to use Medicare Beneficiary Identifier (MBI) instead of Health Insurance Card Number (HICN) for all Medicare claims regardless of service date - claims will reject if submitted with HICN. Update billing software for new HCPCS codes and DRG grouper changes. For autism services, ensure proper RCC 919 coding with specified CPT/HCPCS combinations and obtain prior authorization from Beacon Health Options. Monitor claim status on ctdssmap.com for any suspended DRG/APC claims showing EOB codes 8182 or 8185.

Affected Billing Codes

97158
H0031
H0032
H0046
H2014
90791