CHDP Notice: Upcoming HIPAA Code Conversion and Claim Form Transition

The Department of Health Care Services (DHCS) is continuing its efforts to transition Child Health and Disability Prevention (CHDP) Program policy to comply with Health Insurance Portability and Accountability Act (HIPAA) standards, including the use of national health care electronic transactions and code sets. Throughout the 2017 calendar year, date-of-service-driven CHDP Program policy changes will be implemented in phases to align with HIPAA standards. The first phase is projected to launch in the first quarter of 2017 for clinical laboratory provider services. The transition includes adoption of the CMS-1500 and UB-04 claim forms, and the ASC X12N 837 v.5010A1 transaction to replace the CHDP forms. Plus submission of electronic claims for CHDP services via the HIPAA-compliant 837 standard transaction format or current paper format and reports of the adjudication for CHDP services on Remittance Advice Details (RAD) forms or the 835 Health Care Claim Payment/Remittance Advice (RA). CHDP providers should continue to submit standard and information-only PM 160 forms until DHCS announces the effective date for the transition.