MedicaidAdministrativeMedium impact
Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 24 (Advanced Practice Registered Nurses), and 77 (Physician’s Assistant): Error Code 5528 Updated for Antepartum Procedure Codes
Nevada Medicaid·NV · OB-GYN, Family Medicine·Provider Announcement
Effective date
Jul 17, 2023
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated error code 5528 to allow antepartum care procedure codes 59425 and 59426 to be billed by different provider types within the same billing group. Claims for these codes will no longer deny when another provider in the group has already billed for antepartum care within the 9-month rolling period.
Action Required
Immediately: Nevada Medicaid billing team should resubmit any previously denied claims for CPT codes 59425 and 59426 that were rejected with error code 5528 for dates of service on or after July 17, 2023. Review denial reports and identify affected claims as no automatic reprocessing will occur.