Medi-Cal – Resubmission of Erroneously Denied Claims for Select HCPCS Codes

The Department of Health Care Services (DHCS) identified a claims processing issue affecting claims for select HCPCS codes. This issue caused claims to be erroneously denied with multiple Remittance Advice Details (RAD) codes.

The issue affected claims for dates of service from October 6, 2023, through December 28, 2023. The California Medicaid Management Information System (MMIS) Fiscal Intermediary will resubmit the affected claims. These resubmissions will appear on RAD forms beginning May 23, 2024.

Source: https://mcweb.apps.prd.cammis.medi-cal.ca.gov/assets/703FC765-69B6-428B-997F-62A09D80304D/32911_p44892.pdf?access_token=6UyVkRRfByXTZEWIh8j8QaYylPyP5ULO