REMINDER – Transitions for CHDP services with effective dates of service on or after July 1, 2017
| Date: | June 16, 2017 |
| To: | Health Plan of San Joaquin (HPSJ) Providers |
| From: | Provider Services Department |
| Subject: | REMINDER – Transitions for CHDP services with effective dates of service on or after July 1, 2017 |
| Business: | Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM) |
Effects July 1, 2017
HPSJ is pleased to note that effective July 1, 2017, according to the Federal Health Insurance Portability and Accountability Act (HIPAA) national standards, the PM160 information form will no longer be required.
Helpful information –
- What forms or notices will be discontinued? Confidential Screening/Billing Report (PM 160) claim form.
- Which claim form is used for services provided on or after the transition? For paper submissions, providers will bill using the CMS-1500 or Outpatient UB-04 claim form, or EDI.
- How do CHDP providers bill for the services provided on or after the transition? Providers use the appropriate procedure codes (CPT -4) with specific modifiers according to Medi-Cal billing instructions when billing for these services.
- Are ICD-10-CM diagnosis codes required on my claim? Yes, the policy instructions in the HPSJ provider manual say an ICD-10-CM diagnosis is required for the service being billed.
For more information regarding this notice please visit the DHCS website:
https://files.medi-cal.ca.gov/pubsdoco/chdp_faq.asp
If you have any further questions, please contact our Provider Services Department at (209) 942-6340.