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Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Elizabeth M. Whitehorn, Director

Liletta and Mirena Products Resolution

HFS System Issue:

Effective 4/1/15, HCPCS J7302 was used to bill Liletta and Mirena products.  Since the items have different reimbursement rates, the code was hand-priced through dates of service 12/31/15.  The two IUDs now have separate HCPCS codes, and they no longer need to be hand-priced. 

Problem:

The products were hand-priced by the Department staff, but the system priced claims at $0.00.

Providers Impacted:

Federally Qualified Health Centers and Rural Health Clinics

Procedure Codes Impacted:

J7302

Problem Begin Date:

Claims with dates of service April 01, 2015 through December 31, 2015

Problem Fix Date:

February 24, 2016

Resolution for Impacted Claims:

In order to receive the correct payment amount, providers must submit a replacement claim. 

The Department will accept replacement transactions submitted through MEDI or via 837P files if submitted within 12 months from the original paid voucher date.  To replace a claim, enter Claim Frequency “7”.

Detailed instructions on how to replace a claim electronically can be found in the Chapter 300, 837P Companion Guide.