MedicaidBilling CodesMedium impact
BT202146: Notification of Pregnancy code and modifier (99354 TH) denying for NCCI MUE
Indiana Medicaid (IHCP)·IN · OB-GYN·Provider Bulletin
We identified it
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.
Action Required
Immediately: Continue submitting NOP forms through IHCP Provider Healthcare Portal. For 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. Monitor for mass reprocessing within 60 days of CMS approval.