Medi-Cal: Erroneously Denied Claims for Elderly Multigravida
May 17, 2016The Department of Health Care Services (DHCS) identified a claims processing issue causing claims billed with Ultrasound, pregnant uterus CPT codes 76801-76817 to deny when billed in conjunction with ICD-10-CM diagnosis codes O09.521 – O09.523 (supervision of elderly multigravida). This issue affects claims with dates of service on or after October 1, 2015. DHCS will notify providers when the issue is resolved. Providers should continue to submit claims timely. Affected claims will be reprocessed via an Erroneous Payment Correction (EPC).