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MedicaidReimbursementMedium impact

Hospital Monthly Important Message - 10.10.2019 pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated payment rates for contraceptive devices (Liletta and Etonogestrel implant) effective October 1, 2019, and implemented new claim processing procedures for Medicare exhausted inpatient stays. Hospital billing teams must also be aware that new ICD-10 codes may cause DRG claims to suspend until November when the updated 3M Grouper is loaded.

Action Required

Action needed
Immediately: Update billing system with new Connecticut Medicaid reimbursement rates - Liletta to $749.40 and Etonogestrel implant to $934.82 for dates of service October 1, 2019 and forward. For Medicare exhausted inpatient claims, submit entire crossover claim including total stay rather than cutting back dates of service. Monitor for DRG claim suspensions with EOB codes 0693 or 0920 through November when 3M Grouper updates. Use updated Genetic Testing PA Request Form for all requests after September 1, 2019.

Affected Billing Codes

90378
O10.013
O10.02