Sterilization Billing Guide update

Washington State Health Care Authority sent this bulletin at 08/15/2019 02:34 PM PDT

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Apple Health (Medicaid) Provider Alert

The Health Care Authority (HCA) revised the Sterilization Billing Guide published July 1, 2019.

What has changed?

Added language to include the use of diagnosis code Z30.2 and modifier FP when using HCPCs code 58661 for Family Planning Only Pregnancy-Related and Family Planning Only programs.
Providers may resubmit previously denied claims with these appropriate codes and modifiers for dates of service on and after January 1, 2018.
Added clarifying language for consent form instructions. The specific type of operation must be written on the consent form to prevent claims from being delayed or denied.

For specific details on these changes, see the What is Changed table inside the guide dated August 14, 2019. The updated guide is available on HCA’s Provider billing guides webpage.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than two million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and, beginning in 2020, the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.

Sterilization Billing Guide update

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination