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MedicaidAdministrativeMedium impact

BT2025101: IHCP to mass adjust or reprocess claims for procedure code 91304 that denied incorrectly

Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics·Claims & Billing
Effective date
Jun 11, 2025
We identified it
Jun 18, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) has identified and corrected a system issue that caused COVID-19 vaccine procedure code 91304 claims to be incorrectly denied between January 1 and May 5, 2025. Affected claims have been automatically reprocessed and providers should see corrections on remittance advices starting June 11, 2025.

Action Required

Action needed
Starting June 11, 2025: Billing team should monitor remittance advices for reprocessed claims with ICNs/Claim IDs beginning with 80 (reprocessed denied claims) or 52 (mass replacements). Verify that previously denied COVID-19 vaccine claims for procedure code 91304 with dates of service January 1-May 5, 2025 have been corrected and paid. Contact Gainwell Technologies at 800-457-4584 if expected reprocessed claims are not received.

Affected Billing Codes

91304