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Hospital Monthly Important Message Updated as of 01/10/2018 pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated multiple hospital billing procedures effective January 1, 2018, including new drug codes for Eteplirsen and Nusinersen, increased outlier thresholds, and system fixes for various claim processing issues.
Action Required
Immediately: Update billing system to use new drug codes J1428 for Eteplirsen (replacing C9484) and J2326 for Nusinersen (replacing C9489) effective January 1, 2018. Note that claims with new codes may initially deny until system updates are complete - either hold claims or be prepared to resubmit. Update outlier threshold to $4,150.00 from $3,825.00. For inpatient behavioral health claims, ensure proper Prior Authorization units are documented. Billing team should monitor for system updates and resubmit denied claims once processing systems are updated.