Private Non-Medical Institution Appendix E Code Correction

April 6, 2012

To all providers of PNMI Appendix E “Community Residences for People with Mental Illness” services: The H0020 code has been removed and replaced with T1020 HE . Effective immediately, the T1020 HE must be used on claims regardless of the date of service. This includes new claims and adjustments. Original PAs prior to 4/1/2012 do not need to be replaced; however, a PA for the T1020 HE code is required effective 4/1/12. A plan to fix codes on claims prior to 4/1/2012 is being developed. Unless a claim needs to be adjusted for another reason, providers do not need to adjust these claims. Providers can adjust their claims now if they would like to receive payment more quickly. If the entire claim is denied, providers will need to submit a new claim. Otherwise, you can reverse and re-bill a new claim or reverse and adjust the claims using the T1020 HE code.