Effective for dates of service beginning September 1, 2015, WSI will not reimburse for procedures billed with HCPCS Temporary National Codes (T Codes).
T codes are for exclusive use by Medicaid state agencies; therefore, WSI does not reimburse for these codes. When billing for a service described by a T Code, a provider should select the relevant and permanent CPT® or HCPCS code. If a provider bills a T code, WSI will deny with Reason Code 224:
“This charge is denied because the code submitted is invalid per WSI coding guidelines. Resubmit the charge using the appropriate code. If you disagree with the denial, you may complete the provider request for adjustment form (M6) and submit to WSI within 30 days from the date of the remittance advice. You may also supply any supporting documentation. The patient may not be billed for this reduced or denied charge.”
If you have questions about this article, please send an email to wsipr@nd.gov. To receive provider news, subscribe to our Email Updates list.