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MedicaidBilling CodesHigh impact

BT202109: Coverage and billing information for the 2021 annual HCPCS codes update

Indiana Medicaid (IHCP)·IN · ENT (Ear, Nose & Throat), Pulmonology, Cardiothoracic Surgery +6 more·Claims & Billing
Effective date
Jan 1, 2021
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) has implemented the 2021 annual HCPCS code update with new procedure codes, COVID-19 testing/vaccine codes, and coverage determinations effective retroactively to January 1, 2021. Multiple new surgical, diagnostic, and genetic testing codes are now covered with specific prior authorization requirements and pricing guidelines.

Action Required

Action needed
By March 11, 2021: Billing team must update system with new 2021 HCPCS codes effective retroactively to January 1, 2021. Add prior authorization requirements for genetic testing codes 81168, 81278, and 81279 (limit 1 per lifetime). Update fee schedules and code table documents from in.gov/medicaid/providers. For claims with DOS after January 1, 2021, providers have 90 days for managed care submissions or 180 days for fee-for-service submissions to bypass timely filing limits - include copy of bulletin first page with late claims.

Affected Billing Codes

30468
32408
33741
33745
33746
33995
33997
55880
57465
69705
69706
71271
76145
80143
80151
80161
80167
80179
80181
80189
80193
80204
80210
81168
81191
81192
81193
81194
81278
81279
81338
81339
81347
81348
81351