MedicaidBilling CodesMedium impact
Newsletter Vol. 13, No. 57
New Jersey Medicaid·NJ · General Practice, Wound Care, Geriatrics +1 more·Coding
Effective date
Aug 1, 2003
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJ FamilyCare are adding 15 new HCPCS codes for adult, child, and youth-sized incontinence products (diapers and briefs) with maximum fee allowances ranging from $0.50 to $0.90 per unit, effective August 1, 2003. Additionally, two legacy codes (X7520, X7533) are being deleted effective September 30, 2003. Billing teams must implement these new codes in their systems and remove the deleted codes to avoid claim rejections.
Action Required
By July 25, 2003: Billing team must update billing software and fee schedules to add all 15 new HCPCS codes (A4521–A4535) with their corresponding maximum fee allowances for New Jersey Medicaid and NJ FamilyCare claims. By September 15, 2003: Remove deleted codes X7520 and X7533 from all billing systems and claim submission templates to prevent claim rejections on or after September 30, 2003. Providers of medical supply services must ensure encounter forms and charge capture reflect only active codes. Training staff on correct code selection by specialty (adult vs. child vs. youth sizes) is required. Note: The policy indicates some of these codes require prior authorization—contact the Office of Utilization Management at (609) 588-2724 for clarification on which specific codes need pre-authorization before submitting claims.