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Reprocessing Claims with WHP Procedure Codes
Information posted November 6, 2009: TMHP has identified an issue that impacts claims submitted by Women’s Health Program (WHP) providers or family planning providers for dates of service on or after April 1, 2009 and the following procedure codes: 00851, 58340, 58611, 58615, 58670, 74000, 74010, 81005, 87252, 99001, 99243, E1399, or Q0111. These claims might have been processed incorrectly.
Affected claims will be reprocessed, and payments will be adjusted accordingly. No action on the part of the provider is necessary.
Additionally, claims with dates of service on or after January 1, 2010, and procedure code 58600 will no longer be payable to family planning providers in the office setting (place of service [POS] 1).
For more information, call the TMHP Contact Center at 1-800-925-9126.
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