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MedicaidBilling CodesHigh impact

Newsletter Vol. 12, No. 24

New Jersey Medicaid·NJ · Pathology, Internal Medicine, General Practice·Coding
Effective date
Jan 1, 2002
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid and NJ FamilyCare are updating HCPCS laboratory procedure codes effective immediately, with new code additions (Jan 1, 2002), certain code deletions (June 1, 2002), and reimbursement rate changes (May 1, 2002) to align with Medicare's National Limitation Rate. Independent clinical laboratories must update their billing systems to use the correct codes and fee allowances.

Action Required

Action needed
By June 1, 2002: (1) Billing team must immediately add the 19 new HCPCS codes with their corresponding maximum fee allowances to the billing system for all claims with dates of service on or after January 1, 2002. (2) Remove the 8 deleted codes (80072, 85095, 85102, 85535, 86683, 86683 QW, 88170, 88171) from the billing system for all claims with dates of service on or after June 1, 2002—do not bill these codes after this date or claims will be denied. (3) By May 1, 2002, update reimbursement rates in the billing system for 21 HCPCS codes listed in the fee schedule changes (e.g., 82010 from $10.00 to $9.90, 82190 from $48.00 to $20.60). (4) Laboratory providers must reference the updated Independent Clinical Laboratories Manual and verify all laboratory service codes and fees are accurate in their systems. Consequences: Claims submitted with deleted codes or incorrect fee amounts will be denied; failure to implement changes by the effective dates will result in claim rejections and payment delays.

Affected Billing Codes

82274
82570
82679
82947
83001
83002
83605
83950
84460
86141
86336
86618
87198
87199
87449
87802
87803
87804
88380
80072
85095
85102
85535
86683
88170
88171
82010
82042
82190
82300
82397
82485
82495
82634
82742
82775
82787
82820
83520
83785
83883
85520