Reprocessing Procedure Code 87807 Claims

Procedure code 87807 (Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus), is a service that may be provided to recipients aged 0 to 120. On June 14, 2011, the age range was inadvertently changed allowing only individuals under the age of 1 to be eligible for this service. The age range was corrected on March 12, 2012, and the Department of Public Welfare identified claims that denied with Error Status Code (ESC) 4034 (procedure code vs. age restriction). Because of this error, the department has reprocessed claims that denied for ESC 4034 for dates of service June 14, 2011 through March 12, 2012.