MedicaidBilling CodesMedium impact
2016 CPT and HCPCS Procedure Code Changes
Wisconsin Medicaid (ForwardHealth)·WI · Pulmonology, Oncology, Radiology +3 more·Coding
Effective date
Jan 1, 2016
We identified it
Jun 20, 2026
Summary
ForwardHealth updated CPT and HCPCS codes for 2016, replacing ventilator codes, discontinuing certain orthosis codes, adding new molecular pathology codes, and requiring prior authorization for new ventilator codes E0465 and E0466.
Action Required
By January 1, 2016: Billing team must update system to use new ventilator codes E0465 and E0466 instead of discontinued codes E0450, E0460, E0461, E0463, E0464. Obtain prior authorization for new ventilator codes. Stop billing discontinued orthosis codes L0621 and L0623. Use CPT 81528 for colorectal cancer screening instead of G0464. Use G0297 for low-dose CT lung cancer screening instead of S8032. Claims with old codes will be denied.