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BT202156: Coverage and billing information for the July 2021 HCPCS code update
Effective date
Jul 1, 2021
Identified
Jun 19, 2026
Summary
The IHCP published coverage and billing information for the July 2021 HCPCS update, effective for dates of service on or after July 1, 2021 unless otherwise specified. The July 2021 HCPCS and CPT codes will be added to the claim-processing system, and established pricing will be posted on the appropriate IHCP fee schedule. Covered status, prior authorization and NDC requirements, and prior authorization criteria are listed for the new codes.
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What to do
Action · 8 steps
01Already effective July 1, 2021: For claims with an earlier effective date, providers had 90 days from the July 8, 2021 publication date for managed care claim submission, or 180 days for fee-for-service claim submission, to bypass timely filing limits.
02When submitting claims beyond the standard filing limit, include a copy of the first page of the bulletin.
03Check current applicability before relying on these time frames.
04Billing team: for fee-for-service prior authorization questions, contact Gainwell Technologies at 800-457-4584, option 7; for managed care prior authorization questions, contact the member's managed care entity.
05Newly covered codes carved out of managed care (C9075, C9076, J7168 and M0201) follow fee-for-service guidance.
06For codes that require prior authorization, meet the Table 6 criteria, such as documentation of current clinical status for C9075.
07For discontinued codes, use the alternate codes, such as J0224 in place of C9074 and J7168 in place of C9132.
08Providers may submit, resubmit or adjust fee-for-service claims that were impacted by the delay in publication.
Codes mentioned
906269062790671906779075891304A9593A9594C1761C9074C9075C9076C9077C9078C9079C9080C9132C9778E30.1G0327J0224J1951J7168J9348J9353M0201M0247M0248Q0244Q0247Q5123
Original notice
BT202156: Coverage and billing information for the July 2021 HCPCS code update
in.gov · Always check the source before changing claims.
Related changes
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Related policy hubs
Indiana Medicaid (IHCP) policiesIN policy changesOncologyHematologyInfectious DiseaseUrologyGastroenterologyPodiatryCode 90626Code 90627Code 90671Code 90677Code 90758Code 91304Code A9593Code A9594Code C1761Code C9074Code C9075Code C9076Code C9077Code C9078Code C9079Code C9080Code C9132Code C9778Code E30.1Code G0327Code J0224Code J1951Code J7168Code J9348Code J9353Code M0201Code M0247Code M0248Code Q0244Code Q0247Code Q5123