Resubmission of Erroneously Denied Sonography Claims

The Department of Health Care Services (DHCS) identified a claims processing issue affecting certain claims for CPT codes 76801, 76802, 76805, 76810 – 76812 and 76815 – 76817 billed with ICD-10-CM diagnosis codes O09.521 – O09.523. This issue caused claims to erroneously deny with Remittance Advice Details (RAD) code 9109: This service is not payable for the diagnosis billed. The issue affected claims for dates of service from October 1, 2015, through May 23, 2016. No action is required on your part. Xerox State Healthcare, LLC will resubmit the affected claims. These resubmissions will appear on RAD forms beginning November 3, 2016, with Claim Control Number (CCN) roll number 55 (Resubmit). The roll number is the fifth and sixth digits of the CCN.