Medi-Cal – Reprocessing of Erroneously Paid and Denied Claims of COVID Procedure Codes

The Department of Health Care Services (DHCS) identified a claims processing issue affecting claims for select COVID-19 procedure codes. This issue caused some claims to erroneously pay and some claims erroneously deny with the following Remittance Advice Details (RAD) codes, resulting in both claim overpayments and denials. The issue affected claims for dates of service from June 1, 2023, through October 30, 2023.