New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 56 - MANUAL FOR DENTAL SERVICES
Subchapter 3 - HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
Section 10:56-3.1 - Introduction
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The New Jersey Medicaid/NJ FamilyCare program utilizes the American Dental Association's Code on Dental Procedures and Nomenclature as published in the Current Dental Terminology (CDT) and incorporated herein by reference, as amended and supplemented, and designated by the Centers for Medicare & Medicaid Services (CMS) as the national standard for reporting dental services under the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191. The CDT is published by, and may be obtained from, the American Dental Association, 211 East Chicago Ave., Chicago, Illinois 60611, http://www.ada.org/ and/or PMIC, 4727 Wilshire Blvd., Suite 300, Los Angeles, CA 90010, http://www.medicalcodingbooks.com. Revisions to the CDT (code additions, code deletions and replacement codes) will be reflected in this chapter through publication of a notice of administrative change in the New Jersey Register. Revisions to existing reimbursement amounts specified by the Department and specification of new reimbursement amounts for new codes will be made by rulemaking in accordance with the Administrative Procedure Act, N.J.S.A. 52:14B-1 et seq.
(b) The HCPCS codes listed in this subchapter are divided into 11 sections.
Section 3.2-Diagnostic
Section 3.3-Preventive
Section 3.4-Restorative
Section 3.5-Endodontics
Section 3.6-Periodontics
Section 3.7-Prosthodontics, Removable
Section 3.8-Maxillofacial Prosthetics
Section 3.9-Prosthodontics, Fixed
Section 3.10-Oral Surgery
Section 3.11-Orthodontics
Section 3.12-Adjunctive General Services
(c) The basic categories and their assigned code series are as follows:
(d) Specific elements of the HCPCS which require the attention of the dental provider are as follows:
(e) Alphabetic and numeric symbols under "IND" & "MOD" and notes under "DESCRIPTION"
(f) Listed throughout this subchapter are some general and specific policies of New Jersey Medicaid/NJ FamilyCare program relevant to HCPCS. For complete and specific policies in addition to those outlined herein, the practitioner must consult N.J.A.C. 10:56-1 and/or 2.
(g) This subsection sets forth an index by dental procedure of codes in this subchapter.