MedicaidBilling CodesHigh impact
Newsletter Vol. 14, No. 16
New Jersey Medicaid·NJ · Dentistry·Provider Notice
Effective date
Apr 1, 2004
We identified it
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.
Action Required
By March 31, 2004: Billing 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. Specifically: (1) Replace Y2115 with D1510 52; (2) Replace Y2125 and Y2125 22 with D9999 and D9999 22 respectively; (3) Replace Y3005 with D9999 52; (4) Replace Y3333 with D0120 22; (5) Stop billing Y2105, Y2105 52, Y2310, Y2510, Y2515 YL, Y2515 YU, and Y3334 entirely (no replacement codes). Update claim scrubbing rules to reject any remaining Y-codes submitted after April 1, 2004. Notify all dentists and FQHC providers of these code changes immediately. For codes deleted since July 1, 2003 (Y2105 76 replaced with D4355 76, and Y2505 replaced with D5899 22), verify these changes are already implemented. Failure to comply will result in claim denials for services submitted with obsolete local codes.