The Indiana Health Coverage Programs (IHCP) has notified practices that it would correct an error in age restrictions on some COVID-19 vaccine and administration codes that led to some claims being denied. It also announced coverage of two additional COVID-19 vaccine and administration codes for Moderna second booster shots.

IHCP Bulletin BT202219 corrects an error on the age restrictions on Healthcare Common Procedure Coding System (HCPCS) codes 91305, 0051A, 0052A, 0053A and 0054A, according to IHCP. 

“These codes are covered for members ages 12 and older. Claims may have denied when submitted for the listed codes with dates of service (DOS) retroactively to Oct. 29, 2021, with explanation of benefits (EOB) 4034 – Service billed not compatible with member's age,” the bulletin states. “Gainwell will mass reprocess or mass adjust impacted fee-for-service (FFS) claims submitted.”

IHCP Bulletin BT202237 covers additional COVID-19 vaccine and administration codes for Moderna second booster shots for members 50 and older or 8 and older who are immunocompromised. The newly covered CPT codes are 0094A and 91309. 

These and other IHCP bulletins are available on the IHCP Bulletins homepage.