2023-02: NICU Hospital Claims Reimbursement

Date: 02/10/23

Louisiana Healthcare Connections has identified a claims processing error affecting Neonatal Intensive Care Unit (NICU) claims reimbursement. In most scenarios reviewed, the NICU revenue code reimbursement was underpaid or denied inappropriately by our claims processing team.
 
As per LDH guidelines, NICU claims should always be billed with Revenue code 174. These services will be reimbursed based on the Medicaid fee schedule blended NICU rate.
 
Providers who billed NICU claims with revenue code 174, should take no action at this time. Louisiana Healthcare Connections will recycle claims by February 25, 2023. Providers who billed NICU claims with different revenue codes; should submit corrected claims using revenue code 174 as directed. Please advise if you have any questions.