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Additional Second Quarter 2023 HCPCS Updates

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

On July 11, 2023, the Centers for Medicare & Medicaid Services (CMS) released revised second quarter 2023 Healthcare Common Procedure Coding System (HCPCS) files, resulting in additional updates.

Updates for Added Procedure Codes

The previously added procedure code J9321 has been removed and will no longer be a valid procedure code for dates of service on or after July 1, 2023.

Effective July 6, 2023, procedure code J0174 has been added as a noncovered procedure code for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

Updates for Revised Procedure Codes

The descriptions for the following previously revised procedure codes have an additional revision that will be effective April 18, 2023:

Procedure Codes

0124A

0134A

0144A

0154A

0164A

 

The effective date for the revised description of procedure code 0173A has been changed to April 18, 2023.

The descriptions for the following procedure codes have been revised, effective April 18, 2023:

Procedure Codes

0121A

0141A

0142A

0151A

0171A

0172A

0174A

 

 

The description for procedure code J9323 has been revised, effective July 1, 2023.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.