Date: March 19. 2021
To: Enrolled Hospitals: Chief Executives Officers, Chief Financial
Officers, and Patient Accounts Managers
Re: Update to Inpatient Delivery Claims
Containing LARC Device Codes
This notice is a follow-up to the February 8, 2021 provider notice regarding payment of inpatient delivery claims
containing long acting reversible contraceptive (LARC) device codes. The
APR-DRG information below applies to claims for both Medicaid
fee-for-service and HealthChoice Illinois managed care plans.
A system issue had prevented claims grouping to APR-DRG 560 from
receiving the LARC device add-on payment. Effective February 25, 2021, the
issue was resolved for fee-for-service claim billing, and claims grouping to APR-DRG
560 are now pricing correctly. Any claims that were previously billed and did
not receive the add-on should be voided and rebilled at this time.
Providers should contact the individual managed care plan for guidance on
rebilling any affected managed care claims.
Questions may be directed to a hospital billing consultant in the Bureau
of Professional and Ancillary Services at 877-782-5565 or the applicable
HealthChoice Illinois managed care plan.
Kelly Cunningham, Administrator
of Medical Programs