The 837 Version 4010A1 Health Care Claim Companion Guide has been updated to reflect the following changes:

1. For dates of service on or after July 1, 2006, Medi-Cal will accept vision claims using the updated ASC X12N 837 v.4010A1 Professional Medical transaction or the HCFA 1500 claim form. Medi-Cal interim codes, qualifying codes and the Payment Request for Vision Care and Appliances (45-1) claim form will no longer be accepted for dates of service on or after July 1, 2006.



2. Effective immediately, the Companion Guide has been updated to include the crosswalk information from the paper claim form (Payment Request for Long Term Care [25-1], HCFA 1500 and UB-92 Claim Form) box/field numbers to the ASC X12N 837 v.4010A1 Professional/Institutional transactions to assist interpretation.



3. As of December 27, 2005, Medi-Cal also accepts fax and electronic attachments for ASC X12N 837 v.4010A1 electronic claims.

The updated 837 Version 4010A1 Health Care Claim Companion Guide is available on the ASC X12N Version 4010A1 Companion Guides and NCPDP Technical Specifications Web page.

Additional Resources

For more information, in-state providers may call the Telephone Service Center (TSC) at 1-800-541-5555, 8 a.m. to 5 p.m., Monday through Friday. Border providers, software vendors and out-of-state billers who bill for in-state providers should call the Border Provider Line at (916) 636-1200, 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m., Monday through Friday.

Providers may continue to obtain claim status information by calling the TSC or the Provider Telecommunications Network (PTN) at 1-800-786-4346 (in-state providers) or (916) 636-1950 (out-of-state, border and local providers). A paper Claims Inquiry Form (CIF) may also be used to inquire about or trace a claim for which payment has not been received.