COVID-19 CPT/HCPC Codes - Attention: Providers of Behavioral Health, Community Support, and Rehabilitative and Community Support Services - COVID-19 FAQs - NCCI Claims Paid in Error - Claims with ICD-10 Diagnosis Codes Paid in Error

COVID-19 CPT/HCPC Codes, CR 93723, CR 93924, and CR 93918

The following codes have been updated in MIHMS with the effective dates listed in the table. Six CPT codes indicated below will be opened temporarily during the COVID-19 emergency. These codes support telehealth and telephonic evaluation and management. For more detail about the codes to support these services, please see MaineCare’s Telehealth Summary of New Codes and Information document on MaineCare’s COVID-19 webpage. 

One new HCPC code, U0002, will be available for COVID-19 testing effective February 4, 2020 when the second quarter coding update is available from the Centers for Medicare and Medicaid Services (CMS). Providers will be notified when the code is available. Please hold claims until that time.

If you have billing questions, please call Provider Services at: 1-866-690-5585. Please see our COVID-19 webpage for more provider and policy guidance related to COVID-19. 

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Attention: Providers of Behavioral Health, Community Support, and Rehabilitative and Community Support Services - COVID-19 Frequently Asked Questions (FAQs)

Please see the new FAQs regarding behavioral health services and COVID-19 that were added to MaineCare’s COVID-19 webpage today. If you have questions about these FAQs and/or policies, please contact your provider relations specialist or call Provider Services at 1-866-690-5585. Questions regarding services administered through the Office of Behavioral Health can be sent to OBH.Townhall@maine.gov or by contacting your Program and Contract Specialists

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National Correct Coding Initiative (NCCI) Claims Paid in Error, TR 92359

An issue was discovered where certain NCCI claims have been paid in error. This issue is related to providers who bill for vaccine administration codes and Evaluation & Management (E/M) codes for the same day. If the E/M service is significantly identifiable, then the claim line must contain an appropriate modifier for the system to pay. Previously, the claims were paying even though a modifier was not included. Claims that paid in error will be reprocessed. No provider action is needed.  

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Claims with ICD-10 Diagnosis Codes Paid in Error, TR 93822

An issue was discovered where ICD-10 diagnosis codes that were end dated continued to process for payment in MIHMS. This has resulted in some claims being paid in error. Affected claims will be reprocessed, and no provider action is needed.