Summary
New Jersey Medicaid and NJ KidCare programs have updated HCPCS procedure codes for podiatric services effective January 1, 1998, with additional deletions effective July 1, 1998. Billing teams must add new surgical and medicine codes, remove deleted codes, replace obsolete orthotic supply codes with new ones, and apply new qualifiers to orthotic codes L3001, L3010, L3020, L3030, L3040, L3050, and L3060.
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What to do
Action · 8 steps
01REQUIREMENTS:
- By January 1, 1998: Billing team must update billing software to add new surgical HCPCS codes (G0127, 11055, 11056, 11057, 11719, 17003, 17004, 17111, 29891, 29892, 29893) with corresponding maximum fee allowances and add new medicine codes (99344, 99345, 99347, 99348, 99349, 99350).
02Update encounter forms to reflect new code options.
03- By July 1, 1998: Billing team must remove deleted surgical codes (11050, 11051, 11052, 17001, 17002, 17010, 17100, 17101, 17102, 17104, 17105, M0101) and medicine codes (99351, 99352, 99353) from billing system.
04Configure system to reject these codes with error message for service dates on or after July 1, 1998.
05- Immediately: Billing team must replace orthotic supply codes in the system (W2650→X4890, W2655→X4891, X4800→L3010, X4801→L3020, X4802→L3030, X4803→L3010, X4804→L3010, X4805→L3020) effective January 1, 1998.
06Update billing software to require selection of new qualifiers for codes L3001, L3010, L3020, L3030, L3040, L3050, and L3060 (e.g., Custom Spenco Device, Any Custom Leather/Metal Device, Off-The-Shelf Spenco, etc.) to ensure accurate billing.
07- Update Podiatry Services Manual Chapter 3 with the attachment supplement to this Newsletter and retain documentation numerically behind the blue "5" Newsletter tab for audit trail.
08- Failure to implement these changes will result in claim denials for non-compliant codes and rejected claims for deleted codes.
Codes mentioned
G0127110551105611057117191700317004171112989129892298931105011051110521700117002170101710017101171021710417105M0101993449934599347993489934999350993519935299353W2650W2655X4800X4801X4802X4803X4804X4805X4890X4891L3001L3010L3020L3030L3040L3050L3060
Original notice
Newsletter Vol. 8, No. 40
njmmis.com · Always check the source before changing claims.
Related changes
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New Jersey Medicaid policiesNJ policy changesPodiatryCode G0127Code 11055Code 11056Code 11057Code 11719Code 17003Code 17004Code 17111Code 29891Code 29892Code 29893Code 11050Code 11051Code 11052Code 17001Code 17002Code 17010Code 17100Code 17101Code 17102Code 17104Code 17105Code M0101Code 99344Code 99345Code 99347Code 99348Code 99349Code 99350Code 99351Code 99352Code 99353Code W2650Code W2655Code X4800Code X4801Code X4802Code X4803Code X4804Code X4805Code X4890Code X4891Code L3001Code L3010Code L3020Code L3030Code L3040Code L3050Code L3060