MedicaidPrior AuthMedium impact
BT202407: Additional updates made to the October 2023 quarterly HCPCS code update
Indiana Medicaid (IHCP)·IN · Rheumatology, Neurology, Dermatology +3 more·Claims & Billing
Effective date
Oct 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) has made A9697 (iron oxide injection) non-covered and now requires prior authorization for corticotropin injections J0801 and J0802, with specific age-based and diagnosis criteria that must be met for approval.
Action Required
Immediately: Stop billing A9697 (iron oxide injection) as it is now non-covered and will be denied. For J0801 and J0802 (corticotropin injections), billing team must obtain prior authorization before administration and verify NDC requirements. Update billing system to flag these codes for PA verification. Providers must document specific diagnosis criteria and age requirements per Table 2 before requesting authorization.