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Newsletter Vol. 3, No. 29
Act
by May 1, 2024
Effective date
May 1, 2024
Identified
Jun 20, 2026
Summary
New Jersey Medicaid is updating HCPCS procedure codes for pathology and laboratory services, effective May 2024. Providers must transition to new coding nomenclature for laboratory services, with specific codes now non-covered. A revised subchapter with complete code mappings and reimbursement amounts will be issued separately.
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What to do
by May 1, 2024 · 4 steps
01Billing team must obtain the revised HCPCS subchapter from the New Jersey Division of Medical Assistance and Health Services to identify all updated pathology and laboratory procedure codes and their corresponding Medicaid reimbursement amounts.
02Update billing software to reflect new HCPCS codes and remove non-covered codes from claim submission logic.
03Providers must use only approved codes from the pathology and laboratory section; failure to use updated codes will result in claim denials.
04Contact Phyllis Valeri Bruschini (Laboratory Consultant, Office of Medical Affairs and Provider Relations) if clarification is needed on specific codes.
Original notice
Newsletter Vol. 3, No. 29
njmmis.com · Always check the source before changing claims.
Related changes
See all New Jersey Medicaid changes →Newsletter Vol. 2, No. 42HighNo effective date · Medical PolicyNewsletter Vol. 3, No. 01MediumNo effective date · Provider NoticeNewsletter Vol. 3, No. 02MediumNo effective date · Medical PolicyNewsletter Vol. 3, No. 03LowNo effective date · Provider NoticeBrowse every New Jersey Medicaid change in the policy list