MedicaidBilling CodesHigh impact
Annual Update - Outpatient Hospitals (1) 2017 Annual Update - CMAP's Addendum B (2) JW Modifier (3) Coding Changes
Connecticut Medicaid (HUSKY Health)·CT · Diagnostic Imaging, Physical Therapy, Occupational Therapy·Coding
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) updated billing requirements effective January 1, 2017, including new JW modifier requirements for discarded single-use drugs, updated mammography CPT codes with integrated CAD services, and new complexity-based physical/occupational therapy evaluation codes. Hospital outpatient providers must use new coding structures and document drug waste appropriately.
Action Required
By January 1, 2017: Billing team must update coding for Connecticut Medicaid claims: 1) Replace old mammography codes (77055/77056/77057) with new codes (77065/77066/77067) that include CAD services, 2) Replace PT/OT evaluation codes (97001-97004) with new complexity-based codes (97161-97168), 3) Implement JW modifier billing for discarded single-use drugs on separate line items with required medical record documentation of amounts administered and discarded. Update billing software rules and train staff on new modifier requirements to ensure proper reimbursement.