Modification To Codes That Require Filing To Third-Party Insurers

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Effective for dates of service on or after Jan. 1, 2017, and as required by federal regulation, the South Carolina Department of Health and Human Services (SCDHHS) will implement cost-avoidance rules for the procedure codes reflected below. Service providers will be required to file the claim to any third-party insurer before the claim submission to SCDHHS for payment. Claims filed with SCDHHS with the procedure codes reflected below, before billing all third-party insurers, will receive all applicable claim edits. Resolution of applicable claim edits for the issue described above is outlined in the appendices of each SCDHHS provider manual located at https://www.scdhhs.gov/provider-manual-list .

 

90460

90837

92508

97530

H0001

S9446

 

 

90461

90846

96101

99366

H0005

V5011

 

 

90791

90847

97001

99367

L3999

V5090

   

90792

90849

97003

99381

S5102

V5264

 

 

90832

90853

97110

99391

S8185

 

 

 

90834

92507

97150

99420

S9445

 

 

 

           

Please refer any questions or concerns regarding this bulletin to the Provider Service Center at (888) 289-0709.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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