N.J. Admin. Code § 10:59-2.2

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:59-2.2 - Elements of HCPCS Coding System which require the attention of the provider

(a) The list of HCPCS procedure codes in 10:55-2.4 is arranged in tabular form with specific information for each code given under columns with the titles "HCPCS Code", "Description", and "Maximum Fee Allowance".

(b) The column titled "Maximum Fee Allowance" indicates the maximum amount of reimbursement or the following symbol:

1. "B.R." (By Report) is listed instead of a dollar amount. It means that additional information will be required in order to properly evaluate the service. Attach a copy of the provider's invoice or manufacturer's price list to the claim form.

(c) Services and procedures may be modified under certain circumstances. When applicable, the modifying circumstances should be identified by the addition of alphabetic and/or numeric characters at the end of the HCPCS procedure code. The New Jersey Medicaid program's recognized modifier codes for medical supply services are as follows:

1. "NU" Purchase of new Durable Medical Equipment (DME); and

2. "RR" DME rental service.

N.J. Admin. Code § 10:59-2.2

Amended by R.2005 d.430, effective 12/5/2005.
See: 37 N.J.R. 2991(a), 37 N.J.R. 4555(a).
Deleted former (c)2 and recodified former (c)3 as (c)2.