Modification to Codes that Require Filing to TPL

PROVIDER ALERT

The list of Current Procedural Terminology (CPT) codes below require Third Party Liability (TPL) billing before the claim is submitted to SCDHHS for payment. As a reminder, claims that do not bill TPL first will receive a 150 edit (TPL cover verified/filing not indicated on claim). Providers should follow resolution steps as outline in the SCDHHS Physicians, Laboratories and Other Medical Professionals policy manual.

20664 90474 99382 99392 A4340 S0316 90460 97001 99393 D1206 S4989 90461 97003 99383 99394 G0389 S9140 90471 99241 99385 99420 G0439 90473 99381 99391 A4268 S0315 90472 99384 99401 G0438 S9446 V5264 V5265

This applies to physicians, physician assistants, nurse practitioners and nurse midwives for the SCDHHS fee-for-service program. Please refer any questions or concerns regarding this alert 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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