COVID-19 #32 – FL Codes | Eligibility and Enrollment

Update: FL Codes

On July 1, 2020, Partners released Provider Alert COVID-19 #29 Utilization Management Update for COVID-19 Flexibilities Update providing instruction on the use of Innovations FL modifier codes. This alert is an update regarding the usage of those codes.

It has come to our attention that these codes are receiving upstream Medicaid denials due to issues related to the modifier. Partners has made responsive adjustments to address this issue as noted in the chart below. All codes listed below that previously ended with FL will be end dated in AlphaMCS, effective Aug. 31, 2020 and replaced with the same code ending in CR, with an effective date of July 1, 2020. Providers impacted by upstream Medicaid denials will be contacted and asked to submit the denied claims using the “CR” code in place of the “FL” code that was previously billed.

The following FL codes will remain available for use with a new requirement:

• The base code and the FL code may not be billed on the same day as subsequent claims on these codes will deny for non-compatibility.
  • Example: S5150 and S5150FL may not both be billed on Aug. 26, 2020.

If you have questions, please reach out to either:

• Partners I/DD Utilization Management Workgroup, 704-884-2605
• Partners Claims Department, claimsdepartment@partnersbhm.org; 704-842-6486

Reminder from Member Eligibility & Enrollment: Household Annual Income Field

Please note that when submitting an enrollment or client update request, if the member is notated as “Employed Full Time” or “Employed Part Time,” there must be a valid amount in the “Household Annual Income” amount. If the member is employed, this field cannot be $1.

If a valid amount is not reflected in the “Household Annual Income” field, the enrollment or client update request will be sent back to the provider for correction to insert a valid annual income.

If you have any questions, please contact Eligibility & Enrollment via email at eligibilityenrollment@partnersbhm.org or contact us at 1-888-235-4673.