Prior authorization is now required for CPT code 81161

Effective May 15, 2015, the Indiana Health Coverage Programs (IHCP) will require prior authorization (PA) when providers bill for CPT code 81161 – DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis. This change applies to dates of service on or after May 15, 2015. This PA requirement applies to services delivered under the fee-for-service (FFS) delivery system.