MedicaidBilling CodesHigh impact
Medicaid Alert - MA-2003-05
New Jersey Medicaid·NJ · Dentistry, Oral & Maxillofacial Surgery·Provider Notice
Effective date
Jul 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid adopted CDT4 dental procedure codes effective July 1, 2003, replacing previous CDT3 and legacy codes. Dental providers must now report CDT4 codes for all services provided on or after this date, with the Unisys claims processing system automatically matching new codes to previously authorized procedures. The alert provides FAQs on code usage, common billing errors, and contact procedures for prior authorization corrections and claim denials.
Action Required
By July 1, 2003: Billing team must immediately transition all dental claim submissions to CDT4 procedure codes for services provided on or after this date. Update billing software and encounter forms to use only CDT4 codes listed in this alert for diagnostic services (D0150, D0140, D0160), composite restorations (D2390-D2394), amalgams (D2140-D2161), extractions (D7111, D7140, D7472, D7473), orthodontics (D8080 with modifiers), and anesthesia (D9220-22). For services with existing prior authorizations using old codes issued before July 1, 2003, providers must contact the Medicaid Dental Bureau (1-800-782-0181) with the prior authorization number and service date to request code conversion. Do NOT bill claims with pre-July 1 codes after the effective date—Unisys will deny them with Error Code 742. Verify all prior authorization notifications (Form FD-362) for accuracy before providing treatment. Train all billing staff on the 'NO CROSSWALK' concept: codes without a CDT4 equivalent cannot be billed and may no longer be covered (example: D4220 gingival curettage is no longer a Medicaid benefit). Claims denied for previously extracted teeth require film documentation submitted to the Dental Bureau (P.O. Box 713, Trenton, NJ 08625). Failure to use correct CDT4 codes will result in automatic claim denials by Unisys.