CHDP Notice: Phase 1 Clinical Laboratory Only Transition Update

The Department of Health Care Services (DHCS) is continuing its efforts to transition Child Health and Disability Prevention (CHDP) program policy to comply with HIPAA standards, including the use of national health care electronic transactions and code sets. The transition to bill with national forms (CMS-1500 or UB-04) or equivalent electronic claims is a date of service cutover. Effective for dates of service on or after February 1, 2017, all CHDP clinical laboratory-only services must be billed using HIPAA-compliant standards. Transitioning lab providers to submit national CPT codes on CMS-1500, UB-04 or equivalent electronic claims is Phase 1 of an overall CHDP code conversion. Phase 2 will transition CHDP providers who render well-child health assessments, immunizations and lab services in a single encounter to billing with the national claim formats.