MedicaidBilling CodesHigh impact
Newsletter Vol. 30, No.05
New Jersey Medicaid·NJ·Provider Notice
Effective date
Feb 4, 2020
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid (NJ FamilyCare) established billing procedures for COVID-19 testing claims using HCPCS code U0002 (effective April 1, 2020 for independent labs; February 4, 2020 for CDC tests). Providers must use specific ICD-10-CM diagnosis codes when submitting COVID-19-related claims, with different codes required for confirmed cases, exposures, and suspected cases with symptoms.
Action Required
Immediately: Billing team must update claims submission procedures for all NJ FamilyCare COVID-19 testing claims. (1) For independent laboratories: Begin using HCPCS code U0002 via HIPAA 5010 or Direct Data Entry (DDE) for non-CDC tests. For hospital labs: Temporarily use revenue code 229 with procedure code U0002 until July 1, 2020 (expect updated guidance by then). (2) Billing team must implement ICD-10-CM coding requirements in billing system: use B97.29 ONLY for confirmed COVID-19 cases with specific symptom codes (J12.89, J20.8, J40, J22, J98.8, J80); use Z03.818 for ruled-out exposures; use Z20.828 for actual COVID-19 exposure; use symptom codes (R05, R06.02, R50.9) for suspected cases without definitive diagnosis. Do NOT assign B34.2 or B97.29 for suspected/probable COVID-19. Providers and billing staff must apply these coding rules immediately to all new COVID-19 claims. Failure to use correct procedure and diagnosis codes will result in claim denials from NJ FamilyCare.