Pt Memorandum

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					                                       MEMORANDUM
TO:            All Hospitals
FROM:          EDS and NH Medicaid
DATE:          August 2008
SUBJECT:       Procedure Codes Required on Outpatient Hospital Claims

Please note that effective with dates of service (DOS) beginning September 1, 2008, NH Medicaid
will expand the list of revenue codes that require the submission of a corresponding HCPC/CPT
code. This requirement is already in place for laboratory and radiology services. The additional
revenue codes that will require a corresponding HCPC/CPT code are listed below. The laboratory
and radiology revenue codes are also included for your convenience.

Revenue Codes Requiring Corresponding Procedure Codes for Outpatient Services Effective
September 1, 2008, DOS

Any claim submitted with any of the following revenue codes for outpatient services must also
contain the corresponding HCPC/CPT code.

                                260-269
                                273-277
                                280-290
                                300-369
                                380-620
                                622-637
                                681-709
                                720-729
                                730-799
                                820-821
                                900-989

When Form Locator 42 contains one of the above listed revenue codes:
   1. Form Locator 43 should contain the national description of the revenue code as per the
      NUBC (National Universal Billing Committee), AND
   2. Form Locator 44 must contain the appropriate HCPC/CPT code.

Beginning September 1, 2008, if claims are submitted for DOS of September 1, 2008 or later, and
revenue codes are submitted without the corresponding HCPC/CPT code, claims will not be denied.
You will receive an informational Explanation of Benefits (EOB) reminding you of the requirement
to include HCPC/CPT codes.

Beginning October 1, 2008, claims for DOS of September 1, 2008 or later will be denied if they do
not indicate a corresponding HCPC/CPT code for the above revenue codes.

If you have any questions regarding this notice, covered codes, or billing for these services, please
contact the Communications Unit at: 1-800-423-8303 (NH & VT only) or (603) 224-1747.

				
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