2008 CPT-4 CODE Replacements

This notice is to advise you that Peach State identified an issue with a select group of 2008 CPT-4 codes that were replaced by new codes in 2009. The affected codes range in dates of service from 10/01/2008 to 12/31/2008. Claims that fall within this date range may appear on your EOP with a denial code of EXND – This is a deleted code at the time of service.

On January 21, 2009, we corrected the system and we are currently running reports to identify and correct claims that were denied in error. Any claims that were denied inappropriately as a result of this issue will automatically be adjusted. There is no need to resubmit these claims or file an appeal for claims denials associated with this system issue.

 Diagnosis Code Denials

Note: You may also see an EXND denial code associated with certain claims that were billed with an inappropriate diagnosis code that requires a 3^rd, 4th and or 5^th digit.  Please review these denials to ensure that you are utilizing the correct ICD-9 code and correct and resubmit any claims that were billed with an incorrect diagnosis code.

We apologize for any inconvenience this may have caused you and will work diligently to ensure that there are no further issues. Please contact the Provider Solutions department at (866) 8740633 if you have questions or need additional clarification.

Thank you

Peach State Health Plan

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