Medi-Cal REPROCESSING OF COVID-19 VACCINE ADMINISTRATION CLAIMS FOR TIMELINESS DENIAL AND CUTBACK

The Department of Health Care Services (DHCS) identified a claims processing issue affecting COVID-19 claims billed with various vaccine administration codes.This issue caused claims to erroneously deny or cutback with timeliness with Remittance Advice Details (RAD) codes.

No action is required on your part. The California Medicaid Management Information System (MMIS) Fiscal Intermediary will resubmit the affected claims. These resubmissions will appear on RAD forms beginning September 15, 2022, with Claim Control Number (CCN) roll number 55 (Resubmit).

Source: https://files.medi-cal.ca.gov/pubsdoco/epc/2022/31899_p44061.pdf