Date Posted: May 28, 2026

This Billing and Coding article has been revised and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: January 1, 2026

Summary of Article Changes: Effective 01/01/2026

Under Article Text: Added back references to the -52 modifier, with the added statement for dates of services prior to 01/01/2026

Under CPT/HCPCS Modifiers: Group 1: Paragraph - The modifier -52 should be used only when billing for HGNS performed before January 1, 2026.

Group 1: Modifier - Added the 52 modifier.

Under ICD-10 codes that support Medical Necessity: In the previous revision ICD-10 codes Z68.35, Z68.36, Z68.37, Z68.38 and Z68.39 were removed as they were added in error.

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