Date: October 15, 2020
To: Enrolled Hospitals: Chief Executive Officers; Chief Financial Officers; and Patient Accounts Managers
Re: Inpatient Claims Containing LARC Device Codes May Now be Submitted
This notice provides updated guidance to hospitals for inpatient claims containing long-acting reversible contraceptive (LARC) HCPCS codes. The claim instructions below apply only to participants covered under traditional Medicaid fee-for-service.
By provider notice dated July 13, 2020, hospitals were instructed to hold inpatient claims with discharges beginning July 1, 2020, that contained a LARC device code. System changes were needed to allow the LARC device to price as an add-on amount to the APR-DRG payment determined for the inpatient delivery. Those changes are now finalized, and the inpatient claims may be submitted.
Questions regarding this notice may be directed to a hospital billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.
Interim Medicaid Administrator