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TO: IRHC Providers
Effective May
16, 2018, Medicaid will enforce Alabama Medicaid Administrative Code RuleNo.
560-X-8-.03 Reimbursement. As a result,
the following
procedure codes may no longer be billed and paid outside the IRHC provider encounter
rate. Providers should continue listing these procedure codes when filing
claims for reimbursement.
·
92551
PURE TONE HEARING TEST AIR
·
99173
VISUAL ACUITY SCREEN
·
96110
DEVELOPMENTAL SCREEN W/SCORE
·
96127
BRIEF EMOTIONAL OR BEHAVIORAL ASSESSMENT (smoking cessation)
Claims that are billed using the
non-IRHC number for reimbursement will be monitored on a post payment review
process. Claims that are filed and paid with these procedures outside of the
encounter rate will be subject to recoupment.
Contact the Provider Assistance
Center at 1-800-688-7989 if you have received denials for the four codes listed
above when billing and using the non-IRHC number. A call center associate will review your file
and advise you on how to proceed with refiling the claim.
Any other questions should be
directed to Calvin Binion at calvin.binion@medicaid.alabama.gov.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2018 American Medical
Association and © 2018 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.