MedicaidBilling CodesHigh impact
Newsletter Vol. 3, No. 54
New Jersey Medicaid·NJ · Dentistry, Oral & Maxillofacial Surgery·Provider Notice
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is reinstating the requirement to use quadrant designation codes (UL, UR, LL, LR) when billing for specific dental procedures. Effective September 2024, all claims for the listed periodontal and oral surgery procedures must include the appropriate quadrant code in Field F (Tooth Code) on dental claim forms, or claims will be pended for duplicate editing.
Action Required
By September 1, 2024 (retroactive): Billing team must update all dental claims submitted on or after this date to include mandatory quadrant codes (UL/UR/LL/LR) in Field F of the MC dental claim form. Affected procedures are: Gingivectomy, Gingivoplasty, Gingival Curettage, Periodontal Scaling and Root Planing, Apically Repositioning Flap, Alveoloplasty (with or without extraction), Alveoloplasty Ridge Extension, Vestibuloplasty, Occlusal Adjustment, Osseous Surgery, and Removal of Exostosis. Ensure units are entered in Field D (Units Requested). Providers and billing staff must verify all affected procedure codes include quadrant designation to prevent claim denials with Edit Code 'Claim Exceeds Limit of One Unit of Service.' Update billing software, encounter forms, and staff training immediately. Failure to include quadrant codes will result in claim pends and delays.