Resubmission of Denied Family PACT Laboratory Claims

The Department of Health Care Services (DHCS) Office of Family Planning is amending Family PACT (Planning, Access, Care and Treatment) Program policy for billing laboratory claims. Family PACT laboratory claims require the use of the enrolled Family PACT group National Provider Identifier (NPI) in the referring provider field of the claim form, if the referring provider is part of a group.  Laboratory providers who were denied for dates of service on or after July 1, 2010, with Remittance Advice Detail (RAD) code 9518: The referring provider must be a Family PACT certified provider are to resubmit claims with the enrolled (individual or group) Family PACT NPI in the referring NPI field of the claim form. Timeliness edits will be waived for affected claims resubmitted before March 24, 2013.

Source: November 2012 | Bulletin 62