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Provider Notice Issued 02/08/2021

 

Date:   February 8, 2021

 

To:       Enrolled Hospitals:  Chief Executives Officers, Chief Financial Officers, and Patient Accounts Managers

 

Re:      Inpatient Delivery Claims Containing LARC Device Codes

 

 

This notice informs hospitals of a payment issue for inpatient delivery claims containing a Long Acting Reversible Contraceptive (LARC). The APR-DRG information below applies to claims for both Medicaid fee-for-service and HealthChoice Illinois managed care plans.  

 

Via informational notice dated June 24, 2020, the Department instructed providers to use a LARC procedure code on the inpatient institutional claim format for dates of service beginning July 1, 2020, to prompt an add-on payment to the APR-DRG reimbursement. However, a system issue has prevented claims grouping to APR-DRG 560 from receiving the

add-on.  

 

Until the system issue is corrected, claims that group to APR-DRG 560 will not receive the

add-on. The Department will notify providers by informational notice when the issue is resolved.

 

Questions may be directed to a hospital billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

 

 

Kelly Cunningham, Administrator

Division of Medical Programs​


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JB Pritzker, Governor • Theresa Eagleson, Director