IHCP implements taxonomy code requirement changes

In Indiana Health Coverage Programs (IHCP) Bulletin BT201768, the IHCP outlined revised guidance regarding claim submission requirements. The bulletin stated that taxonomy codes would no longer be required for attending and operating providers on institutional claims and for ordering, prescribing, or referring (OPR) providers on any claim type. These changes were to be effective October 29, 2017, however, a temporary delay was subsequently announced on October 26, 2017.

The IHCP will implement the announced changes to taxonomy code requirements effective November 29, 2017. As stated in BT201768, these changes apply to fee-for-service (FFS) and managed care claims regardless of submission format and are retroactive to dates of claim submission on or after February 13, 2017.

Beginning November 29, 2017, providers may resubmit FFS claims if they believe their claims were denied inappropriately due to taxonomy codes. Claims resubmitted beyond the original one-year filing limit must include a copy of this banner page as an attachment and be filed within one year of the publication date. Providers should check with the individual managed care entities (MCEs) for additional information regarding the resubmission or reprocessing of managed care claims.