Medi-Cal Update

Chiropractic | August 2019 | Bulletin 527

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1. Clarification on Chiropractic Services Coverage and Claim Information

Effective retroactively for dates of service on or after May 1, 2017, providers may be reimbursed for chiropractic services when billed in conjunction with one of the following ICD-10-CM diagnosis codes:

ICD-10-CM Code Description
S13.4XXA – S13.4XXS Sprain of ligaments of cervical spine
S16.1XXA – S16.1XXS Strain of muscle, fascia and tendon at neck level
S23.3XXA – S23.3XXS Sprain of ligaments of thoracic spine
S29.012A – S29.012S Strain of muscles and tendon of back wall of thorax
S33.5XXA – S33.5XXS Sprain of ligaments of lumbar spine
S33.6XXA – S33.6XXS Sprain of sacroiliac joint
S33.8XXA – S33.8xxS Sprain of other parts of lumbar spine and pelvis
S39.012A – S39.012S Strain of muscle, fascia and tendon of lower back

Program coverage for chiropractic services is updated to clarify the scope of covered Medi-Cal services. In addition, chiropractic services claim information is expanded to identify covered Medi-Cal services.

An Erroneous Payment Correction (EPC) will be issued to reprocess affected claims. No action is required of providers.

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
Chiropractic chiro (3)
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2. September 2019 Medi-Cal Provider Seminar

The September Medi-Cal Provider Seminar is scheduled for September 17 – 18, 2019, at the Visalia Convention Center in Visalia, California. Providers can access a class schedule for the seminar by visiting the Provider Training web page of the Medi-Cal Learning Portal (MLP) and clicking the seminar date(s) they would like to attend. Providers may RSVP by logging in to the MLP.

Throughout the year, the Department of Health Care Services (DHCS) and the California Medicaid Management Information System (MMIS) Fiscal Intermediary (FI) for Medi-Cal conduct Medi-Cal training seminars. These seminars, which target both novice and experienced providers and billing staff, cover the following topics:

Providers must register by September 3, 2019, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After September 3, 2019, the workbooks will be available only by download on the Medi-Cal Provider Training Workbooks web page of the Medi-Cal website.

Note:

Wi-Fi will not be provided at the seminar. Please plan accordingly.

Providers that require more in-depth claim and billing information have the option to receive one-on-one claims assistance, which is available at all seminars, in the Claims Assistance Room.

Providers may also schedule a custom billing workshop. On the Lookup Regional Representative web page, enter the ZIP code for the area you wish to search and click the “Enter ZIP Code” button. The name of the designated field representative for your area will appear on the map. To contact a regional representative, providers must first contact the Telephone Service Center (TSC) at 1-800-541-5555 and request to be contacted by a representative.

Providers are encouraged to bookmark the Provider Training web page and refer to it often for current seminar information.

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4. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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