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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2018

Billing Diagnosis Codes for Preventive Services

As you are aware, as a result of the Patient Protection and Affordable Care Act, Harvard Pilgrim requires that specific in-network preventive services be covered for members without cost sharing. Harvard Pilgrim would like to remind providers in our network that all diagnosis codes for preventive, screening, counseling, or wellness services should be billed in the primary position when indicated. Billing the appropriate diagnosis code in the primary position helps ensure that your claim will be accurately processed.

For more information regarding Harvard Pilgrim’s coverage of preventive services and a detailed list of diagnosis codes, please refer to the Patient Protection and Affordable Care Act (Federal Health Care Reform) section of Harvard Pilgrim’s commercial online Provider Manual.

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Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator