MedicaidAdministrativeMedium impact
BT2024212: IHCP identifies system issue for procedure code L5926
Indiana Medicaid (IHCP)·IN · Orthopedics, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Dec 26, 2024
We identified it
Jun 19, 2026
Summary
The Indiana Health Coverage Programs (IHCP) identified and corrected a system issue that incorrectly denied claims for HCPCS code L5926 (prosthetic knee component) when billed by DME suppliers from January 1, 2024 onward. Providers can now resubmit previously denied claims within 180 days of December 26, 2024.
Action Required
By June 24, 2025: Billing team should identify any L5926 claims for prosthetic knee components that were denied since January 1, 2024 when billed by DME suppliers. Resubmit these claims to IHCP within the 180-day window and include a copy of bulletin BT2024212 with late submissions to satisfy timely filing requirements.