MedicaidBilling CodesHigh impact
Newsletter Vol. 10, No. 11
New Jersey Medicaid·NJ·Provider Notice
Effective date
Jan 1, 1999
We identified it
Jun 20, 2026
Summary
Procedure code K0164 for oropharyngeal suction catheters has been discontinued and is no longer valid for billing. Home health agencies must immediately replace all claims using K0164 with procedure code A4628 instead. This correction applies retroactively to claims with service dates on or after January 1, 1999.
Action Required
Immediately: Billing team must update all billing system rules, templates, and fee schedules to discontinue use of procedure code K0164. Replace K0164 with A4628 for all oropharyngeal suction catheter claims, including any pending or previously submitted claims with service dates on or after January 1, 1999. Audit recent claims submitted with K0164 and resubmit with A4628 to prevent denials. Update home health agency billing staff on this code change. Contact the Chief, Pharmaceutical Services at (609) 588-2724 with questions.