Resubmission of Erroneously Denied Family PACT Program Claims

The Department of Health Care Services (DHCS) identified a claims processing issue affecting certain Family Planning, Access, Care and Treatment (Family PACT) Program claims. This issue caused claims to erroneously deny with Remittance Advice Details (RAD) code 0202: The primary diagnosis code is invalid for the age of the recipient. The issue affected claims for dates of service from November 10, 2015, through April 11, 2016. No action is required on your part. Xerox State Healthcare, LLC (Xerox) will resubmit the affected claims. These resubmissions will appear on RAD forms beginning August 25, 2016, with Claim Control Number (CCN) roll number 55 (Resubmit). The roll number is the fifth and sixth digits of the CCN.