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MedicaidBilling CodesMedium impact

Newsletter Vol. 9, No. 36

New Jersey Medicaid·NJ · Orthopedics, Physical Therapy·Coding
Effective date
Jan 1, 1999
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid and NJ KidCare have added new HCPCS procedure codes for prosthetic and orthotic services effective January 1, 1999, with maximum fee allowances. Additionally, two orthotic codes (L4310, L4320) are being deleted effective June 30, 1999. Billing teams must update their coding systems and fee schedules to reflect these additions and deletions.

Action Required

Action needed
By June 30, 1999: Billing team must (1) Add six new HCPCS codes to billing system for prosthetic and orthotic services with corresponding maximum fee allowances: L1690 ($1,040.29), L1847 ($309.42), L3675 ($85.92), L5968 ($1,958.73), L5975 ($249.89), L5988 ($1,076.78), L6693 ($1,530.26), L8015 ($30.58), L8035 ($1,974.74); (2) Delete codes L4310 and L4320 from the active billing system to prevent claims submission; (3) Update the Prosthetics and Orthotic Services Manual, Subchapter 2 (HCPCS) with the provided supplement. File all documentation behind the blue Newsletter Tab marked '5'. Failure to implement these changes will result in claim rejections for services billed with deleted codes after June 30, 1999, and incorrect reimbursement for new codes if maximum fees are not configured properly.

Affected Billing Codes

L1690
L1847
L3675
L4310
L4320
L5968
L5975
L5988
L6693
L8015
L8035