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HIPAA: Code Conversions

The Health Insurance Portability and Accountability Act (HIPAA) mandated the standardization of internal (administrative) code sets and the use of standard service/procedure code sets for transactions. The Medi-Cal program is using a phased approach to convert its interim (local) codes to national values. To assist providers with this conversion, Medi-Cal has created correlation tables for the following code sets (implementation is based on dates of service as specified in the below documents):

CODE CORRELATION TABLES

Administrative Code Sets Service/Procedure Code Sets 276/277 Claim Status Request and Response Transaction 835 Transactions