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New Jersey MedicaidMedicaid · Billing Codes · Coding · NJ · Pathology, Infectious DiseaseHigh impact

Newsletter Vol. 10, No. 23

Act
by Jan 1, 2000
Effective date
Jan 1, 2000
Identified
Jun 20, 2026

Summary

New Jersey Medicaid and NJ KidCare are adding eight new HCPCS laboratory procedure codes effective January 1, 2000, deleting six obsolete codes effective April 1, 2000, and reducing the reimbursement rate for HIV-1 Viral Load Test (code 87536) from $126.00 to $117.00 effective January 1, 2000. Independent clinical laboratories and hospitals must update billing systems to use new codes and remove deleted codes by the applicable effective dates.

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What to do

by Jan 1, 2000 · 4 steps
01Billing team must immediately update the billing system to add the eight new HCPCS codes (80048, 80053, 80069, 80074, 80076, 82120, 87338, and 87536) with their maximum fee allowances.
02Update fee schedules for New Jersey Medicaid and NJ KidCare programs in billing software.
03By April 1, 2000: Remove or inactivate the six deleted HCPCS codes (80049, 80054, 80058, 80059, 80091, 80092) from the billing system and train staff to use replacement codes.
04Immediately: Update the reimbursement rate for HIV-1 Viral Load Test (87536) from $126.00 to $117.00 in all claim processing systems.
If missed: Failure to implement these changes will result in claim denials or payment delays for New Jersey Medicaid and NJ KidCare beneficiaries.

Codes mentioned

80048800538006980074800768212087338875368004980054800588005980091800928658886403870818743087880

Original notice

Newsletter Vol. 10, No. 23
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 9, No. 54HighEffective Oct 1, 1999 · CodingNewsletter Vol. 10, No. 02HighEffective Oct 1, 1999 · CodingNewsletter Vol. 10, No. 01MediumNo effective date · CodingNewsletter Vol. 10, No. 03LowNo effective date · PharmacyBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesPathologyInfectious DiseaseCode 80048Code 80053Code 80069Code 80074Code 80076Code 82120Code 87338Code 87536Code 80049Code 80054Code 80058Code 80059Code 80091Code 80092Code 86588Code 86403Code 87081Code 87430Code 87880

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