Summary
New Jersey Medicaid has added 10 new HCPCS laboratory/pathology codes effective January 1, 2002, deleted 7 codes effective June 1, 2002, and reduced reimbursement rates for 10 existing laboratory codes effective May 1, 2002 to align with Medicare National Limitation Rates. Hospitals must update billing systems to use new codes and apply reduced fee schedules immediately.
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What to do
Action · 4 steps
01IMMEDIATE ACTION REQUIRED - By January 1, 2002: Billing team must update hospital billing system to add 10 new HCPCS laboratory codes (82274, 83950, 86141, 86336, 87198, 87199, 87802, 87803, 87804, 88380) with their corresponding maximum fee allowances for all Medicaid and NJ FamilyCare claims.
02By May 1, 2002: Reduce reimbursement rates in billing system for 10 codes (82010, 82042, 82300, 82397, 82485, 82495, 82634, 82742, 82775, 82787, 82820, 83785, 85520) per the updated fee schedule.
03By June 1, 2002: Remove/block submission of 7 deleted codes (80072, 85095, 85102, 85535, 86683, 88170, 88171) from billing software to prevent claim denials.
04Update all internal billing references and encounter forms.
If missed: Failure to implement changes by effective dates will result in claim denials or incorrect reimbursement for Medicaid/NJ FamilyCare laboratory services.
Codes mentioned
822748395086141863368719887199878028780387804883808007285095851028553586683881708817182010820428230082397824858249582634827428277582787828208378585520
Original notice
Newsletter Vol. 12, No. 26
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Related policy hubs
New Jersey Medicaid policiesNJ policy changesPathologyInternal MedicineGeneral PracticeCode 82274Code 83950Code 86141Code 86336Code 87198Code 87199Code 87802Code 87803Code 87804Code 88380Code 80072Code 85095Code 85102Code 85535Code 86683Code 88170Code 88171Code 82010Code 82042Code 82300Code 82397Code 82485Code 82495Code 82634Code 82742Code 82775Code 82787Code 82820Code 83785Code 85520