Resubmission of Erroneously Denied Claims for CPT Code 81479

The Department of Health Care Services (DHCS) identified a claims processing issue affecting certain claims billed with CPT code 81479 (for dates of service from July 1, 2013, to September 16, 2016). This issue caused claims to erroneously deny with Remittance Advice Details (RAD) codes 0196: This procedure requires a modifier; modifier is not present and 0036: RTD (Resubmission Turnaround Document) was either not returned or was returned uncorrected; therefore, your claim is formally denied. No action is required on your part. Conduent will resubmit the affected claims. These resubmissions will appear on RAD forms beginning May 4, 2017, with Claim Control Number (CCN) roll number 55 (Resubmit).

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INDUSTRY NEWS TAGS: California Medi Cal

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