Medi-Cal Update

Hospice Care Program | September 2018 | Bulletin 528

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1. 2019 ICD-10-CM/PCS Diagnosis Code Annual Update

Effective for dates of service on or after October 1, 2018, the Centers for Medicare & Medicaid Services (CMS) has added ICD-10-CM and ICD-10-PCS diagnosis codes for the 2019 ICD-10-CM/PCS annual update.

Information and downloads for these codes can be found at the ICD-10 page of the CMS website. Specific billing policy related to this update will be published in a future Medi-Cal Update.

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2. Modifiers on TARs: Provider Manual Instructions Enhanced

Instructions for entering one or more modifiers on 50-1 Treatment Authorization Request (TAR) forms are updated in the TAR Completion section of the Part 2 Medi-Cal provider manual.

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

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
Audiology and Hearing Aids
Chronic Dialysis Clinics
Clinics and Hospitals
Durable Medical Equipment
General Medicine
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Centers
Inpatient Services
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
tar comp (9)
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3. Authorized Drug Manufacturer Labeler Codes Update

The Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes section has been updated as follows.

Terminations, effective July 1, 2018
NDC Labeler Code Contracting Company’s Name
63032 STIEFEL LABORATORIES

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

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
AIDS Waiver Program
Chronic Dialysis Clinics
Clinics and Hospitals
Expanded Access to Primary Care Program
General Medicine
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Program
Multipurpose Senior Services Program
Obstetrics
Pharmacy
Rehabilitation Clinics
drugs cdl p5 (14)
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4. October 2018 Medi-Cal Provider Seminar

The October Medi-Cal provider seminar is scheduled for October 16 – 17, 2018, at the Crown Plaza in Concord, 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 DHCS 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 October 2, 2018, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After October 2, 2018, the workbooks will be available only by download on the Medi-Cal Provider Training Workbooks 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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5. Valid Revenue Codes for Outpatient Services

For dates of service on or after January 1, 2019, a four-digit revenue code must be included on outpatient claims billed on paper UB-04 claim forms (Box 42) or ANSI 837I transactions for electronic billing (FL42; reference ASC X12N 837 v.5010 Loop 2400 Segment SV201).

A revenue code identifies specific accommodations, ancillary services, or unique billing calculations or arrangements. As defined by the National Uniform Billing Committee (NUBC) and required by the HIPAA, services covered in an outpatient setting require a valid four-digit revenue code to accompany the CPT and HCPCS national procedure code(s).

Outpatient claims with dates of service on or after January 1, 2019, that are submitted on paper UB-04 claim forms or ANSI 837I transactions with missing, incomplete, or invalid revenue codes will be denied.

Providers may contact the Telephone Service Center TSC) at 1-800-541-5555 for claims assistance.

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6. Get the Latest Medi-Cal News: Subscribe to MCSS Today

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The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails shortly after urgent announcements and other updates post on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form

  2. Enter your email address and ZIP code and select a subscriber type

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

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7. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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