Can state-created procedure codes that begin with a W or Y be billed after July 1, 2000?
For dates of service prior to July 1, 2000 it is acceptable to bill a state-created procedure code. After July 1 date of service, the appropriate CPT procedure code should be billed, except for the state-created codes that have not changed. • How does a local health department resolve denied claims? Health department staff should review the Remittance and Status Advice report and read the denial Explanation of Benefit (EOB). The EOB provides guidance on how to correct a billing error. The claim can be resubmitted as a new claim when the EOB instructs providers “to correct and resubmit.” Health departments can also contact EDS Provider Services at 1-919-851-8888 or 1-800-688-6696 for assistance. • When a child is seen for a periodic or interperiodic Health Check screening (W8010 or W8016) does the health department need to list CPT codes on the claim form for every immunization given? Yes. Health departments are required to list on the claim form the procedure code for each immunization
