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Erroneously Denied Claims for HCPCS Code J7307 with ICD-10-CM Code Z30.018

November 17, 2015

The Department of Health Care Services (DHCS) has identified a claims processing issue causing claims to erroneously deny for HCPCS code J7307 when billed with ICD-10-CM code Z30.018 (encounter for initial prescription of other contraceptives). These claims are being denied with Remittance Advice Details (RAD) code 9109: This service is not payable for the diagnosis billed.

DHCS is correcting this issue and will alert providers when the issue is resolved. Providers should continue to submit claims in a timely manner. Affected claims will be reprocessed via an Erroneous Payment Correction (EPC). Providers are encouraged to check the Medi-Cal website regularly for updates regarding this issue.