Claims Processing Issue with Submitting Pathology Codes

The Department of Health Care Services (DHCS) is aware of a claims processing issue affecting the following pathology codes billed without an attachment. The issue affects claims submitted for dates of service on or after October 1, 2015. These claims are receiving Remittance Advice Details (RAD) code 188: This is a “By Report” procedure. No report is attached or the attached report is insufficient to warrant payment. Impacted providers should continue to resubmit or appeal denied claims with appropriate delay reason codes and documentation.