MedicaidBilling CodesHigh impact
Newsletter Vol. 14, No. 20
New Jersey Medicaid·NJ·Provider Notice
Effective date
Apr 1, 2004
We identified it
Jun 20, 2026
Summary
New Jersey is discontinuing certain local procedure and modifier codes effective April 1, 2004. Providers must replace deleted codes with equivalent national CPT/HCPCS codes (e.g., Z1481 → T1005 22, Z1482 → S9125) or discontinue billing entirely where no replacement exists. This affects HCBS Community Care Waiver claims for developmentally disabled populations.
Action Required
By April 1, 2004: Billing team must update billing software to replace all instances of deleted local codes with national codes per the conversion table. Specifically: (1) Replace Z1481 with T1005 22; (2) Replace Z1482 with S9125; (3) Replace Z1534 with T2018; (4) Remove Z1471, Z1483, Z1538, Z1539, Z1540, Z1542, Z1543 from all billing templates and claims—these have no replacements and cannot be billed. Update all encounter forms, templates, and superbills used by providers. Verify all historical claims submitted before April 1, 2004 using deleted codes are resubmitted with correct codes. Train billing staff and providers on the new codes. Claims submitted on or after April 1, 2004 using old local codes will be rejected by New Jersey MMIS. Consequences: Claim denials and revenue loss if providers continue billing deleted codes.