MedicaidCoverageMedium impact
BT2023143: IHCP updates age restriction for ICD-10 CM diagnosis code Z00.01
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice·Claims & Billing
Effective date
Sep 30, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) updated age restrictions for ICD-10 diagnosis code Z00.01 (general adult medical examination with abnormal findings) to ages 15 and older, effective retroactively to September 30, 2022. Claims that were previously denied in error will be automatically reprocessed and appear on remittance advices starting November 29, 2023.
Action Required
By November 29, 2023: Billing team should monitor remittance advices for automatically reprocessed claims with ICNs/Claim IDs beginning with 80 (reprocessed denied claims) or 52 (mass replacements). Ensure future claims with Z00.01 are only submitted for patients ages 15 and older. No manual action required as claims are being automatically adjusted by IHCP.