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Newsletter Vol. 14, No. 31
Act
by Mar 31, 2004
Effective date
Apr 1, 2004
Identified
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare are discontinuing local procedure and modifier codes (W-series, Z-series, Y-series) effective April 1, 2004. Providers must replace these codes with equivalent national CPT and HCPCS codes on all claims submitted on or after this date. Some codes have no replacement and must be discontinued entirely.
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What to do
by Mar 31, 2004 · 8 steps
01Billing team must update all billing software and claim submission systems to STOP using all W-series, Z-series, and Y-series local procedure codes.
02Replace with equivalent national CPT/HCPCS codes listed in this policy for Medicaid and NJ FamilyCare claims.
03Identify any deleted codes with NO REPLACEMENT CODE (W1001, W1001 AA, W2650, W2655, W5760 76, W9096 22 52, W9096 52, W9097 52, W9098 52, W9200, W9333 52, W9334 52, W9335 52, W9337, W9338, W9338 52, Z0250 WM, Z0335, Z4000, W9820 WM, W9821-W9827, W9847-W9857, Z1100, Z1105, Z1110, Y7563) and implement workflow to prevent submission of these codes—claims with deleted codes will be denied.
04Update modifier mappings (AV→SA, WM→SB, WB→78, YD→UD, YY→SM, ZZ→SN, WT→EP) in billing software for all claim types (electronic and hard-copy).
05Verify mappings differ by provider type: EPSDT providers use different replacements than HealthStart/independent clinics.
06Providers must use corrected codes for all dates of service on or after April 1, 2004.
07Training required for all billing staff and providers on new code requirements.
08Claims submitted with old local codes after April 1, 2004 will be rejected.
Codes mentioned
50360668202231536005494205741550978594149087090744907469094593268J9217J1950J931093736785969920359425594269610097799975359250799381993919938299392993859939559409594105940059514H0004
Original notice
Newsletter Vol. 14, No. 31
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 32, No.13MediumEffective May 1, 2022 · Medical PolicyNewsletter Vol. 12, No. 84MediumEffective Sep 9, 2002 · Provider NoticeMedicaid Alert MA2021-01HighEffective Apr 20, 2021 · CodingNewsletter Vol. 32, No.03MediumEffective Jan 1, 2022 · Provider NoticeBrowse every New Jersey Medicaid change in the policy list
Related policy hubs
New Jersey Medicaid policiesNJ policy changesCode 50360Code 66820Code 22315Code 36005Code 49420Code 57415Code 50978Code 59414Code 90870Code 90744Code 90746Code 90945Code 93268Code J9217Code J1950Code J9310Code 93736Code 78596Code 99203Code 59425Code 59426Code 96100Code 97799Code 97535Code 92507Code 99381Code 99391Code 99382Code 99392Code 99385Code 99395Code 59409Code 59410Code 59400Code 59514Code H0004