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Case Management Changes from Local Codes to National Codes

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Case Management for Children and Pregnant Women

Because of changes required by HIPAA (Health Insurance Portability and Accountability Act of 1996), effective October 16, 2003, Medicaid claims for case management services will no longer use local codes. Because there are not national codes for each billable component of Case Management for Children and Pregnant Women (CPW) a combination of procedure code and modifiers will be used. The current procedure codes will be not be accepted for dates of service on or after October 16, 2003. Following is a chart to show the new procedure code and modifiers for CPW claims for dates of service beginning October 16, 2003. Changes are being made to TDH Connect and NHIC systems to accommodate these changes. Any provider that is using a payment vendor will need to check to see if changes will need to be made with their method of filing electronic claims.

 

  Local Code National Code Modifiers
All claims for dates of service prior to October 16, 2003 will be filed with local codes.
Comprehensive visit 9100x G9012 U2- Comprehensive visit
U5- face to face contact
Follow-up
visit
9101x G9012 TS- Follow-up service
U5- Face to face contact
9102x G9012 TS- Follow-up service

 

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Last updated September 29, 2010