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Newsletter Vol. 14, No. 27

New Jersey Medicaid·NJ · Orthopedics, General Surgery, Physical Therapy·Provider Notice
Effective date
Apr 1, 2004
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid and NJ FamilyCare are discontinuing local procedure and modifier codes (X-series and XE modifier) effective April 1, 2004. Providers must transition to equivalent national CPT and HCPCS codes for prosthetic and orthotic services. Some local codes have no replacement and must be discontinued entirely.

Action Required

Action needed
By April 1, 2004: Billing team must immediately update all billing software and claims submission systems to discontinue use of all X-series local codes (X3000, X3001, X3002, X0003, X3410, X3435, X3610, X3620, X4000-X4008, X4070, X4280, X4290, X4350, X4355, X4370, X4375, X4450, X4810, X4850-X4854, X4890-X4894, X6006, X6458, X6483-X6484, X6486, X7190, X7200, X7300, X7520, X7533, X8200, X8338-X8339, X8433, X8856, X8862) and XE modifier. For each deleted code, replace with the specified national HCPCS code per the provided crosswalk table (e.g., X3001 becomes L5695, X4070 becomes L0972). For codes marked 'NO REPLACEMENT CODE', remove from coding options entirely—these services cannot be billed to NJ Medicaid/NJ FamilyCare after the effective date. Update encounter forms, fee schedules, and provider documentation to reflect national codes only. Train all billing and coding staff on the mapping table. Any claims submitted on or after April 1, 2004 using deleted local codes will be denied. Prosthetic and orthotic service providers must verify software vendor compliance before the deadline.

Affected Billing Codes

L5695
L5978
L5986
L5690
L5684
L5650
L2785
L2270
L2755
L1960
L1906
L0972
L3580
L3649
L2795
L2800
L4110
L4090
A4209
A4649
E1902
A4930
A4927