Medi-Cal: CHDP HIPAA Code Conversion for Clinical Laboratory Service Providers Coming Soon

Child Health and Disability Prevention (CHDP) participating providers who bill for clinical laboratory services only will start billing lab services according to HIPAA national standards for dates of service on or after February 1, 2017. The transition from billing clinical laboratory services with local two-character CHDP codes on the Confidential Screening/Billing Report (PM 160) to billing national codes on the CMS-1500 or UB-04, or electronic equivalents will be based on a date of service cutover. Transitioning lab providers to submit national CPT codes on CMS-1500, UB-04 or equivalent electronic claims is the first phase of an overall CHDP code conversion. The second phase will transition CHDP providers who render well health assessments, immunizations and lab services in a single encounter to billing with the national claim formats. For services rendered for dates of service on or after February 1, 2017, CHDP clinical laboratory-only providers may submit their claims on the CMS-1500, UB-04 or via the equivalent electronic claim. Medi-Cal billing will be based on providers’ enrollment status with Medi-Cal.