MDIN removes gender restriction from CPT code 87661

Effective November 7, 2014, the Indiana Health Coverage Programs (IHCP) will remove the gender restriction on CPT 87661 – Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, amplified probe technique. The gender restriction was mistakenly added, resulting in inappropriately denied claims for edit 4035 – Procedure code billed not compatible with recipients sex. This change will be applied retroactively to fee-for-service claims with dates of service on or after January 1, 2014. HP will perform a mass reprocessing of claims denied for edit 4035 for dates of service (DOS) beginning January 1, 2014, through November 6, 2014. Providers will see the reprocessed claims on the Remittance Advice (RA) statements dated December 5, 2014, with internal control numbers (ICNs) that begin with region code 80. For claims that were underpaid, the net difference will be paid and reflected on the RA.