MedicaidBilling CodesMedium impact
BT2025146: IHCP announces additional ICD-10-CM coding updates, effective Oct. 1, 2025
Indiana Medicaid (IHCP)·IN · OB-GYN, Podiatry, Optometry·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 18, 2026
Summary
IHCP (Indiana Medicaid) has added new ICD-10-CM diagnosis codes effective October 1, 2025 for three service categories: Presumptive Eligibility for Pregnant Women (PEPW) services, routine foot care coverage, and visual evoked potential testing by optometrists. These changes apply retroactively to all dates of service on or after October 1, 2025.
Action Required
Immediately: Billing team must update coding system to include new ICD-10 qualifying diagnosis codes for Indiana Medicaid patients. Add codes Z59861, Z59868, Z59869 for PEPW services; E11A for routine foot care coverage; and G35A, G35B0, G35B1, G35B2, G35C0, G35C1, G35C2, G35D for optometrist VEP testing. Download updated code sets from in.gov/medicaid/providers. Apply changes retroactively to all claims with dates of service October 1, 2025 and after.