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Family PACT Claims for Laboratory Examinations Are Being Denied

December 29, 2015

The Department of Health Care Services (DHCS) has identified a claims processing issue causing Family Planning, Access, Care and Treatment (Family PACT) Program claims to erroneously deny when billed with ICD-10-CM diagnosis code Z01.812 (encounter for preprocedural laboratory examination).

DHCS 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.