Reprocessing of Erroneously Paid and Denied Claims for Select CPT Codes

The Department of Health Care Services (DHCS) identified a claims processing issue affecting certain claims billed for CPT Codes 77385, 77386 and 77387. This issue caused some claims to erroneously pay and some claims to erroneously deny. The issue affected claims for dates of service from October 1, 2015, through December 3, 2016. No action is required on your part. Conduent will adjust erroneously paid claims and resubmit erroneously denied claims. Some claims will be voided and resubmitted as part of adjustment activity. Adjustments will appear on Remittance Advice Details (RAD) forms beginning October 19, 2017, with RAD code 0893: Retroactive rate adjustment. Resubmissions of denied claims will appear on RAD forms beginning September 21, 2017, with Claim Control Number (CCN) roll number 55 (Resubmit). The roll number is the fifth and sixth digits of the CCN. Voids will appear on RAD forms beginning October 19, 2017, with RAD code 0819: Void and resubmit of claims processed in error, and corresponding resubmits will appear on October 26, 2017, with Claim Control Number (CCN) roll number 55 (Resubmit).