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Elizabeth M. Whitehorn, Director

Provider Notice Issued 03/19/2021

Date:   March 19. 2021

To:       Enrolled Hospitals:  Chief Executives Officers, Chief FinancialOfficers, and Patient Accounts Managers
 

Re:      Update to Inpatient Delivery ClaimsContaining LARC Device Codes

 

 

 

 

 

 

 

This notice is a follow-up to the February 8, 2021 provider notice regarding payment of inpatient delivery claimscontaining long acting reversible contraceptive (LARC) device codes. The

 

APR-DRG information below applies to claims for both Medicaidfee-for-service and HealthChoice Illinois managed care plans.  

 

 

 

A system issue had prevented claims grouping to APR-DRG 560 fromreceiving the LARC device add-on payment. Effective February 25, 2021, theissue was resolved for fee-for-service claim billing, and claims grouping to APR-DRG560 are now pricing correctly. Any claims that were previously billed and didnot receive the add-on should be voided and rebilled at this time.

 

 

 

Providers should contact the individual managed care plan for guidance onrebilling any affected managed care claims.

 

 

 

Questions may be directed to a hospital billing consultant in the Bureauof Professional and Ancillary Services at 877-782-5565 or the applicableHealthChoice Illinois managed care plan.

 

 

 

 

 

 

 

Kelly Cunningham, Administrator

Divisionof Medical Programs​​