MedicaidCoverageMedium impact
BT202580: IHCP updates coverage for physician-administered drug code J0911
Indiana Medicaid (IHCP)·IN · Nephrology·Pharmacy
Effective date
Jul 1, 2024
We identified it
Jun 18, 2026
Summary
Indiana Health Coverage Programs (IHCP) now covers physician-administered drug code J0911 (taurolidine and heparin catheter lock for hemodialysis patients) retroactive to July 1, 2024. The coverage applies to both managed care and fee-for-service with no prior authorization required, and previously denied claims will be automatically reprocessed.
Action Required
By September 3, 2025: Billing team should resubmit any previously denied claims for J0911 with dates of service on or after July 1, 2024, including NDC codes and attaching page 1 of this bulletin for claims beyond standard filing limits. Update billing system to ensure J0911 claims include required NDC codes and link to revenue code 636 for institutional outpatient claims. Monitor remittance advices starting July 9, 2025, for automatically reprocessed claims with ICN numbers beginning with 52 or 80.