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New Jersey MedicaidMedicaid · Billing Codes · Provider Notice · NJ · DentistryHigh impact

Newsletter Vol. 14, No. 16

Act
by Mar 31, 2004
Effective date
Apr 1, 2004
Identified
Jun 20, 2026

Summary

New Jersey Medicaid and NJ FamilyCare are discontinuing local dental procedure and modifier codes effective April 1, 2004. Providers must replace deleted local codes (Y-series) with equivalent national CDT codes or discontinue billing entirely where no replacement exists. This affects dentists and Federally Qualified Health Centers submitting claims for fee-for-service covered services.

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What to do

by Mar 31, 2004 · 9 steps
01Billing team must update billing software and claim submission processes to replace all New Jersey local Y-series codes with their national CDT equivalents per the provided mapping table.
02Replace Y2115 with D1510 52.
03Replace Y2125 and Y2125 22 with D9999 and D9999 22 respectively.
04Replace Y3005 with D9999 52.
05Replace Y3333 with D0120 22.
06Stop billing Y2105, Y2105 52, Y2310, Y2510, Y2515 YL, Y2515 YU, and Y3334 entirely (no replacement codes).
07Update claim scrubbing rules to reject any remaining Y-codes submitted after April 1, 2004.
08Notify all dentists and FQHC providers of these code changes immediately.
09For codes deleted since July 1, 2003 (Y2105 76 replaced with D4355 76, and Y2505 replaced with D5899 22), verify these changes are already implemented.
If missed: Failure to comply will result in claim denials for services submitted with obsolete local codes.

Codes mentioned

Y2105Y2115Y2125Y2310Y2510Y2515Y3005Y3333Y3334D1510D9999D0120D4355D5899

Original notice

Newsletter Vol. 14, No. 16
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 13, No. 47HighEffective Jul 1, 2003 · CodingNewsletter Vol. 20, No. 01MediumEffective Jan 1, 2010 · Provider NoticeNewsletter Vol. 22, No.18MediumEffective Nov 1, 2012 · EligibilityNewsletter Vol. 25, No.14MediumEffective Oct 1, 2015 · EligibilityBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesDentistryCode Y2105Code Y2115Code Y2125Code Y2310Code Y2510Code Y2515Code Y3005Code Y3333Code Y3334Code D1510Code D9999Code D0120Code D4355Code D5899

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