Medicaid Delaware – Attention: Laboratory and Outpatient Providers – Claim Adjustment for Procedure Code G0475

The following procedure code is available for claims submission with an effective date of January 1, 2020.
G0475

• Short Descriptor: HIV Combination Assay
• Long Descriptor: HIV Antigen/Antibody, Combination Assay, Screening

Billing for this code must include diagnosis code Z11.4 – Encounter for Screening for Human Immunodeficiency Virus (HIV).
The DMAP will adjust all previously submitted claims with a date of service from January 1, 2020 through a submission date of November 16, 2020 that included procedure code G0475 and diagnosis code Z11.4. The updated claim will appear on your Remittance Advice (RA) dated December 7, 2020, and the claim number will begin with a ’52’.

Source: https://medicaid.dhss.delaware.gov/provider/Home/tabid/135/Default.aspx