MedicaidBilling CodesMedium impact
BT2022121: Coverage and billing information for the 2023 annual HCPCS codes update
Indiana Medicaid (IHCP)·IN · Orthopedics, General Surgery, Gastroenterology +5 more·Claims & Billing
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP/Medicaid) has added new HCPCS codes for 2023, including several surgical procedures that require prior authorization. Multiple new codes for hernia repairs, spinal disc insertion, and gastric balloon procedures are now covered with specific billing requirements.
Action Required
By January 31, 2023: Billing team must update system to require prior authorization for CPT codes 22860 (spinal disc insertion), 43290 (gastric balloon placement), and 43291 (gastric balloon removal). Update encounter forms to note age restriction (18+ years) for gastric balloon procedures. Configure systems to include bulletin copy for claims submitted beyond standard filing limits (90 days managed care, 180 days fee-for-service).