New Drug Testing Laboratory Codes, HCPCS Codes G0477 through G0483

CMS had an issue with loading the new drug testing lab codes.  Since MaineCare has not received the CMS update pertaining to these codes, claims will not process correctly.  Claims are processed differently depending on the provider type.

• All Providers Submitting UB-04 and CMS1500 Claims: Claims that were submitted before 01/22/16 as an 837I or 837P electronic transaction with codes G0477 through G0483 were rejected through the EDI Gateway. This means the claims did not make it into the MIHMS System.  These claims will require resubmission.

• Providers Submitting CMS1500 Claims: Claims submitted with G0477 through G0483 and processed after 01/22/16 will be denied.  The Remittance Advice will reflect CARC 204. These codes were entered in the system on 02/10/16, and should no longer deny.  Claims that denied in error prior to 02/10/16 will be adjusted.