← Back to list
BT202146: Notification of Pregnancy code and modifier (99354 TH) denying for NCCI MUE
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
CPT code 99354 with modifier TH is currently being denied when billed with E/M services due to NCCI edit conflicts. IHCP is seeking CMS approval to deactivate this edit, and claims will be mass reprocessed within 60 days of approval.
Get alerts when payers change rules like this one
We check Indiana Medicaid (IHCP) and other payers every day and email you when a change matches your specialty and state.
Get Indiana Medicaid (IHCP) alertsPolicy Monitoring is free. No card required.
What to do
immediately · 3 steps
01Continue submitting NOP forms through IHCP Provider Healthcare Portal.
02For denied claims with CPT 99354 + modifier TH billed with E/M services (99202-99215), file disputes with managed care entities for early payment consideration while awaiting CMS approval.
03Monitor for mass reprocessing within 60 days of CMS approval.
Codes mentioned
99354992029920399204992059921199212992139921499215
Original notice
BT202146: Notification of Pregnancy code and modifier (99354 TH) denying for NCCI MUE
in.gov · Always check the source before changing claims.
Related changes
See all Indiana Medicaid (IHCP) changes →BT202120: IHCP announces new revised E/M codes for office visitsHighEffective Jan 1, 2021 · Provider BulletinBT202570: IHCP announces additional COVID-19 coverage changes due to American Rescue Plan expirationHighEffective Oct 1, 2024 · Medical PolicyBT2025120: Claim adjustments to be made for COVID-19 coverage changes due to American Rescue Plan expirationHighEffective Oct 1, 2024 · Claims & BillingBT202636: IHCP corrects claim processing for office visit procedure codes with family planning modifier FPMediumEffective Oct 1, 2024 · Claims & BillingBrowse every Indiana Medicaid (IHCP) change in the policy list