Medi-Cal Update

Multipurpose Senior Services Program | October 2018 | Bulletin 529

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1. HIPAA Notice of Code Conversion for Sign Language Interpreter Services

Effective for dates of service on or after January 1, 2019, HCPCS Level III local codes Z0324 and Z0326 for sign language interpreter services will be replaced with HIPAA-compliant national HCPCS Level II code T1013. HCPCS Level III local codes Z0328 and Z0329 will be terminated.

Sign language interpreter services are a benefit to facilitate effective communication with deaf or hearing-impaired Medi-Cal recipients. Sign language interpreter services are not covered for recipients receiving these services in a health facility required by law to provide sign language interpreter services.

The Sign Language Interpreter Services Code Conversion Crosswalk and additional information for this project will publish as details are determined.

Providers are encouraged to routinely check the Medi-Cal Update bulletin or complete the Medi-Cal Subscription Service (MCSS) Form to receive an email notification for newly published Medi-Cal Update bulletins, Newsflash articles, and/or System Status Alerts.

For additional information, providers may:

All other questions for the sign language interpreter services code conversion may be submitted via email to CAMMISCodeConversion@conduent.com.

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2. Sign Language Interpreter Code Conversion Billing Instructions

Effective for dates of service on or after January 1, 2019, HCPCS Level III local codes Z0324, Z0326, Z0328 and Z0329 for sign language interpreter services will be discontinued. Codes Z0324 and Z0326 will be replaced by national HIPAA-compliant HCPCS Level II code T1013. HCPCS Level II national code T1013 will be required to bill sign language interpreter services. Providers submitting UB-04 claim forms or ANSI 837I transactions must bill revenue codes in addition to national procedure codes. The Sign Language Interpreter Services Code Conversion Crosswalk is available for reference.

Sign language interpreter services are a benefit to facilitate effective communication with deaf or hearing-impaired Medi-Cal recipients. Sign language interpreter services are not covered for recipients receiving these services in a health facility that is required by law to provide sign language interpreter services.

Updated manual pages will be released in a future Medi-Cal Update.

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3. Sign Language Interpreter Services Code Conversion: Frequently Asked Questions

Effective for dates of service on or after January 1, 2019, the sign language interpreter services code conversion replaces HCPCS Level III local codes with HIPAA-compliant HCPCS Level II national billing codes. Providers are encouraged to familiarize themselves with the Sign Language Interpreter Services Code Conversion: Frequently Asked Questions.

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4. Authorized Drug Manufacturer Labeler Codes Update

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

Additions, effective October 1, 2018
NDC Labeler Code Contracting Company's Name
00990 ICU MEDICAL INC.
36000 BAXTER HEALTHCARE CORPORATION
65628 CUTISPHARMA, INC.
69536 FOUNDATION CONSUMER HEALTHCARE, LLC
70010 GRANULES PHARMACEUTICALS, INC.
70255 ARRAY BIOPHARMA INC.
70621 BIOFRONTERA INC.
71045 ACHAOGEN, INC.
71104 BIOVERATIV US LLC
71334 AGIOS PHARMACEUTICALS, INC.
71428 GLASSHOUSE PHARMACEUTICALS LLC
71930 EYWA PHARMA
76336 HRA PHARMA AMERICA INC.
   
Terminations, effective October 1, 2018
NDC Labeler Code Contracting Company's Name
15310 CREEKWOOD PHARMACEUTICAL, INC.
24477 EKR THERAPEUTICS, INC.
24486 ARISTOS PHARMACEUTICALS, INC.
58181 NEXTSOURCE BIOTECHNOLOGY, LLC
58604 SPROUT PHARMACEUTICALS, INC.
69051 PROFOUNDA, INC.
69654 AYTU BIOSCIENCE, INC.

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 (5, 7, 8, 12, 15, 18–20)
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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. National Correct Coding Initiative Quarterly Update for October 2018

The Centers for Medicare & Medicaid Services (CMS) has released the quarterly National Correct Coding Initiative (NCCI) payment policy updates. These mandatory national edits have been incorporated into the Medi-Cal claims processing system and are valid for dates of service on or after October 1, 2018.

For additional information, refer to The National Correct Coding Initiative in Medicaid page of the Medicaid website.

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7. 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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8. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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