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BT202291: IHCP announces dental coding policy changes

Indiana Medicaid (IHCP)·IN · Dentistry·Claims & Billing
Effective date
Nov 27, 2022
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) is implementing new dental coding requirements effective November 27, 2022, specifying which tooth numbers must be used with specific dental procedure codes across all managed care entities. Additionally, a claim processing issue for code D2943 has been corrected for dates of service from January 1, 2021 forward.

Action Required

Action needed
By November 27, 2022: Billing team must update system to enforce specific tooth number requirements for 38 dental procedure codes as specified in the IHCP policy table. Update billing software validation rules to only accept the approved tooth numbers for each code (e.g., D3310 only accepts tooth numbers 6-11, 22-27). Train staff on new tooth numbering requirements and note that D1354 and D1355 require prior authorization for members 21 and older. Monitor for automatically reprocessed D2943 claims beginning December 7, 2022.

Affected Billing Codes

D0220
D0230
D1352
D1354
D1355
D2921
D2930
D2932
D2933
D2943
D2980
D3310
D3330
D3346
D3348
D3410
D3425
D3426
D3430
D4212
D5520
D5640
D5650
D5660
D6081
D7111
D7210
D7220
D7230
D7240
D7241
D7250
D7251
D7270
D7285
D7286
D7510