HCA: Edit code 11120 posting on claims in error

Dental Medicaid

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HCA: Edit code 11120 posting on claims in error

The Health Care Authority (HCA) recently sent the following alert to dental Medicaid providers.

Apple Health (Medicaid) Provider Alert

Attention providers!

Please be aware that claims processed after October 15, 2021, may be posting the prior authorization edit in error. This is causing some services to deny for prior authorization in error.

There is no workaround. The Health Care Authority will reprocess affected claims as soon as the issue is corrected. You do not need to rebill these claims.

Medicaid Transition to Managed Care Cancelled

The 2019 Legislature has directed the Washington State Health Care Authority (HCA) to continue to administer the dental Medicaid program through fee-for-service. The HCA may not proceed with a carved-out or carved-in managed care dental option at this time.

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Questions? Please email info@wsda.org.
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