Update Your System to Remove These Obsolete Drug Codes

BLUECONNECT

Providers

May 2024

In This Issue

►	May news: Executive summary

►	Now available: Annual fee schedule updates (effective July 1)

►	New! AZ Pediatric Psychiatry Access Line

►	New Category III code policy starts July 1

►	Complimentary CNE/CME opportunity for maternity care providers

►

Update your system to remove these obsolete drug codes

Update your system to remove these obsolete drug codes

AZ Blue routinely updates claim systems to deny codes for drugs considered obsolete. Starting July 1, 2024, five additional obsolete drug codes will not be eligible for reimbursement (90634, 90656, 90658, 90661, and 90673).

How drugs get classified as obsolete

Pharmacy medications are classified as obsolete when they are no longer manufactured and are also at least two years past their shelf life. AZ Blue benefit plans exclude drugs that have been classified as obsolete or have not been approved by the FDA.

AZ Blue’s obsolete drug code list

For your convenience, we publish a list of obsolete pharmacy codes on our Claims and Remits page at azblue.com/provider/resources/claims-and-remits, under “Claim Pricing Guidelines-Standard > Other Standard Pricing Guidelines > Obsolete Pharmacy CPT/HCPCS Code Lists.” We deny codes on this list.

Effective July 1, we will be adding five additional codes to the AZ Blue obsolete drug code list—see below for specific information.

(click graphic to enlarge)

How to avoid claim processing delays and denials

Be sure to remind your clinical and billing staff to check our list of obsolete drug codes and update your system and billing processes accordingly. The list includes links to CMS and the National Bureau of Economic Research that you can use to ensure you are using only current CPT/HCPCS codes for the national drug codes on your claims.

Questions?

If you have questions about obsolete drug codes, please reach out to your Provider Relations Contact or call Provider Partnerships at 602-864-4231 or 1-800-232-2345, ext. 4231.

In This Issue

►	May news: Executive summary

►	Now available: Annual fee schedule updates (effective July 1)

►	New! AZ Pediatric Psychiatry Access Line

►	New Category III code policy starts July 1

►	Complimentary CNE/CME opportunity for maternity care providers

►

Update your system to remove these obsolete drug codes

CPT^® (Current Procedural Terminology) codes are © 2024 American Medical Association. All rights reserved.

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