MedicaidBilling CodesHigh impact
Hospital Monthly Important Message Updated as of 05/10/2018 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
May 10, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) updated multiple billing requirements effective May 10, 2018, including new 340B drug modifiers JG and TB required for outpatient claims, updated procedure code units for several HCPCS codes, and new genetic testing prior authorization forms. DXC Technology is also reprocessing claims with incorrect DRG weights and therapy payment issues.
Action Required
Immediately: Update billing system to require modifier JG or TB on all 340B-acquired drugs for outpatient claims (bill type 13X). Update procedure code units: 86631 to 6 units, 86632 to 3 units, 86658 to 12 units, A9517 to 200 units. Begin using new Genetic Testing Prior Authorization Request Forms for all genetic testing requests. Monitor for claim reprocessing adjustments scheduled for June cycles.