MedicaidPrior AuthMedium impact
Newsletter Vol. 20, No. 02
New Jersey Medicaid·NJ · Wound Care·Coding
Effective date
Apr 1, 2010
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid has implemented new billing procedures for disposable incontinence supplies, gloves, and gradient compression stockings, requiring prior authorization for all these items and replacing some HCPCS codes. Two gradient compression stocking codes (A6542, A6543) are being deleted and replaced with different codes for billing.
Action Required
By April 1, 2010: Billing team must obtain prior authorization before billing codes T4521-T4535, A4554 (incontinence supplies), A4927, A4930 (gloves), and A6530-A6541, A6544, A6545, A6549 (compression stockings) for New Jersey Medicaid. Replace deleted code A6542 with A6549 for custom gradient compression stockings and A6543 with A4649 for lymphedema compression stockings. Update billing system to prevent claims submission without prior auth.