Attachments Required for Billing Specific Hematology Tests

Providers are reminded that attachments are required when billing Medi-Cal for CPT codes 86920 (compatibility test each unit; immediate spin technique), 86921 (incubation technique), 86922 (antiglobulin technique) and 86923 (electronic).

Codes 86920, 86921, 86922 and 86923 are all “By Report” codes so attachments are necessary in order for the Department of Health Care Services (DHCS) consultant to price the codes correctly. If attachments are not included when providers bill for these codes, the claim will be denied with Remittance Advice Details (RAD) code 0188: This is a “By Report” procedure. No report is attached or the attached report is insufficient to warrant payment.