MedicaidCoverageLow impact
BT2024169: IHCP updates age restriction for ICD-10-CM diagnosis code O03.30
Indiana Medicaid (IHCP)·IN · OB-GYN, Emergency Medicine, Family Medicine·Claims & Billing
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) is expanding the age restriction for ICD-10 diagnosis code O03.30 (Unspecified complication following incomplete spontaneous abortion) from ages 12-55 to ages 9-64, effective November 1, 2024. This change aligns with CMS guidelines and affects claim processing for this specific diagnosis code.
Action Required
Before November 1, 2024: Billing team should verify that billing system accepts ICD-10 code O03.30 for Indiana Medicaid patients ages 9-11 and 56-64. No system updates should be needed as this is a payer-side change, but staff should be aware that claims with this diagnosis code for the expanded age ranges will now be accepted by IHCP.