Updates to Age Restriction for Procedure Code 90619

July 11, 2022

What is New

Per Health and Human Services Commission (HHSC), Procedure code 90619 is available for individuals two years of age and older.  This update addresses an issue that resulted in some claims for procedure code 90619 for individuals ages 18 years of age or younger denying inappropriately. However, claims for individuals 19 years of age or older were not affected and no changes are required for these claims.

Claims Reprocessing

Affected claims with dates of services July 1, 2020, through May 31, 2022, will be reprocessed. Reprocessing of claims may result in an additional payment to reflect on future Remittance and Status (R&S) reports.

Questions

Providers, for questions or additional information, please: