MedicaidPrior AuthMedium impact
Service Limitation for Procedure Code A4322
Nevada Medicaid·NV·Provider Announcement
Effective date
Apr 7, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has clarified that procedure code A4322 is limited to 4 units per rolling month and requires prior authorization to exceed this limit. Claims exceeding 4 units without prior authorization will be denied with error code 5553.
Action Required
Immediately: Billing team must update system to enforce 4-unit monthly limit for HCPCS code A4322 for Nevada Medicaid patients. Configure system to require prior authorization for quantities exceeding 4 units per rolling month. Update encounter forms and EMR templates to alert providers of the limit. Claims exceeding 4 units without prior authorization will be denied with error code 5553.