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ICD-10-CM Diagnosis Code Updates for Every Woman Counts Program

November 2, 2015

Effective for dates of service on or after October 1, 2015, ICD-10-CM diagnosis codes have been updated for Every Woman Counts (EWC) program. Providers must have an appropriate ICD-10-CM diagnosis code(s) specified as the first or second diagnosis code on the claim to be eligible for reimbursement.

The following ICD-10-CM diagnosis codes have been added for breast cancer diagnoses:
C50.019 D05.02
C50.111 D05.10 – D05.12
C50.112 D05.80
C50.119 D05.81
C50.211 D18.01
C50.212  

The following ICD-10-CM diagnosis codes have been removed for cervical and breast cancer screenings:
C43.59 D03.59 R68.89
C44.509 D22.9 Z04.9
C44.519 D23.9 Z08
C44.529 N92.6 Z71.89
C44.599 P04.8  

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