Claims Corner May 2018
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Providers are encouraged to routinely check the Medi-Cal Update provider bulletins and complete the MCSS Subscriber Form to receive email notifications for newly published Medi-Cal Update bulletins, Newsflash articles and/or System Status Alerts.
Submitting a Corrected Claim—Reminder
- Correcting electronic CMS-1500 claims— enter claim frequency type (billing) code 7, for replacement/correction in the 2300 loop in the CLM*05 03
- Correcting paper CMS-1500 claims—fill out box 22 (resubmission code) to include code 7 to let us know this is a correct or replacement claim. NOTE: Corrected claims should be sent with ALL line items filled out for that claim and they should never be filed with just the line items that need to be corrected.
Changes coming in 2019
Audiology/EPSDT Audiology & Speech Therapy (Therapies—Bulletin 511)
The Audiology/Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Audiology and Speech Therapy code conversion replaces non-HIPAA-compliant HCPCS Level II codes (local codes), with HIPAA-compliant CPT codes. HIPAA mandated these changes to billing requirements for Audiology/EPSDT Audiology and Speech Therapy providers.
Crosswalks and FAQs will be available soon and additional information for this project will publish as details are determined on the MCL website.
Hospice Routine Home Care Updates
* see copy of attached bulletin