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BT202227: Coverage and billing information for the April 2022 quarterly HCPCS code update
Effective date
Apr 1, 2022
Identified
Jun 19, 2026
Summary
Effective for dates of service on or after April 1, 2022, unless otherwise specified, the Indiana Health Coverage Programs (IHCP) added procedure codes from the April 2022 quarterly HCPCS update. The update includes skin-substitute codes reimbursed at a flat, statewide, per-unit rate and newly covered codes linked to revenue code 636. Discontinued codes C9084, C9085, C9086 and C9087 were replaced by J9359, J0219, J0491 and J9071 respectively. Codes listed as noncovered are not covered for any IHCP program.
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What to do
Action · 6 steps
01Already effective April 1, 2022: Check current applicability before acting on these codes.
02Billing team: for A4238 and E2102 continuous glucose monitor supplies, follow the criteria in the Continuous Glucose Monitors section of the Durable and Home Medical Equipment and Supplies provider reference module, since these codes require prior authorization.
03In charge entry, replace discontinued codes C9084, C9085, C9086 and C9087 with J9359, J0219, J0491 and J9071 respectively.
04Bill the skin-substitute codes A2011, A2012, A2013, A4100, Q4224, Q4225, Q4256, Q4257 and Q4258 under their flat, statewide, per-unit rate, with podiatrists (provider specialty 140) as the allowed specialty.
05For telehealth claims, continue using the GT modifier, following guidance in BT2020106.
06Send fee-for-service questions to Gainwell Technologies at 800-457-4584, option 7, and managed care questions to the managed care entity the member is enrolled with.
Codes mentioned
A4238E2102C9084C9085C9086C9087J9359J0219J0491J9071A2011A2012A2013A4100Q4224Q4225Q4256Q4257Q4258C9092C9093V2525
Original notice
BT202227: Coverage and billing information for the April 2022 quarterly HCPCS code update
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT2021113: Coverage and billing information for the 2022 annual HCPCS codes updateMediumEffective Jan 1, 2022 · Claims & BillingBT202229: Manual pricing reimbursement information for select April 2022 quarterly HCPCS codesMediumEffective Apr 1, 2022 · Claims & BillingBT202251: Coverage and billing information for the July 2022 quarterly HCPCS codes updateMediumEffective Jul 1, 2022 · Claims & BillingBT2023114: IHCP summarizes billing guidelines for diabetes testing suppliesMediumEffective Jan 1, 2023 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list
Related policy hubs
Indiana Medicaid (IHCP) policiesIN policy changesPodiatryWound CareEndocrinologyOptometryOphthalmologyCode A4238Code E2102Code C9084Code C9085Code C9086Code C9087Code J9359Code J0219Code J0491Code J9071Code A2011Code A2012Code A2013Code A4100Code Q4224Code Q4225Code Q4256Code Q4257Code Q4258Code C9092Code C9093Code V2525