Alpha-Fetoprotein (AFP) Claims Reprocessing for Procedure Code 82106

Texas Medicaid has identified an issue that affects claims that were submitted with dates of service on or after July 1, 2010, and procedure code 82106. These claims may have denied inappropriately with an EOB that indicated that the age of the client was not appropriate for the procedure code. Effective for dates of service on or after July 1, 2010, procedure code 82106 is a benefit for clients who are 10 through 55 years of age. All affected claims will be reprocessed, and payments will be adjusted accordingly. No action on the part of the provider is necessary.