Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Part 2 – Durable Medical Equipment and Medical Supplies (DME)

111,557 Bytes206,848 Bytes

Medi-Cal Program (00medi-cal)

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Medi-Cal Provider Manual Contents

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Manual Organization (0Amanorg)

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How to Use This Manual (0Bhwtouse)

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Getting Started: Where to Find the Answers (0C get start)

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Contents (Part 2 – Medi-Cal Billing and Policy): Durable Medical Equipment and Medical Supplies (DME) (2toc dme)

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Appeal Form Completion (appeal form)

14,984 Bytes52,736 Bytes

California Children's Services (CCS) Program (cal child)

5,600 Bytes32,768 Bytes

California Children’s Services (CCS) Program Approved Hospitals (cal child appr)

9,823 Bytes32,256 Bytes

California Children's Services (CCS) Program Billing (cal child bil)

460,330 Bytes527,360 Bytes

California Children's Services (CCS) Program Billing Example: CMS-1500 (cal child bil cms)

10,469 Bytes41,472 Bytes

CCS Program Billing Guidelines (cal child bil guide)

20,850 Bytes112,128 Bytes

California Children’s Services (CCS) Program County Office Directory (cal child county)

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California Children's Services (CCS) Program Eligibility (cal child elig)

9,495 Bytes34,304 Bytes

California Children's Services (CCS) Program Medical Therapy Program (cal child med)

21,122 Bytes77,824 Bytes

California Children's Services (CCS) Program Provider Paneling (cal child panel)

16,759 Bytes90,624 Bytes

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Physicians and Podiatrists (DHS 4514)

20,274 Bytes102,912 Bytes

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Allied Health Care Professionals (DHS 4515 )

12,914 Bytes72,704 Bytes

California Children's Services (CCS) Program Referrals (cal child ref)

29,815 Bytes105,984 Bytes

California Children's Services (CCS) Program Service Authorization Request (SAR) (cal child sar)

73,728 Bytes343,552 Bytes

California Children’s Services (CCS) Program Service Code Groupings (cal child ser)

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California Children’s Services (CCS) Program Special Care Centers (cal child spec)

126,123 Bytes209,920 Bytes

CIF Completion (cif co)

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CIF Special Billing Instructions (cif sp)

64,864 Bytes100,864 Bytes

CIF Submission and Timeliness Instructions (cif sub)

564,132 Bytes716,800 Bytes

CMS-1500 Completion (cms comp)

194,573 Bytes257,024 Bytes

CMS-1500 Special Billing Instructions (cms spec)

17,983 Bytes77,824 Bytes

CMS-1500 Submission and Timeliness Instructions (cms sub)

13,571 Bytes51,712 Bytes

CMS-1500 Tips for Billing (cms tips)

17,884 Bytes70,656 Bytes

Correct Coding Initiative: National (correct)

133,630 Bytes174,592 Bytes

Correct Coding Initiative: National – Claim Preparation (correct cod)

24,940 Bytes92,160 Bytes

Durable Medical Equipment (DME): An Overview (dura)

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Form: Certificate of Medical Necessity for All Durable Medical Equipment (DME) (Except Wheelchairs and Scooters) (DHS 6181)

7,333 Bytes40,448 Bytes

Form: Certificate of Medical Necessity for Apnea Monitors (MC 4600)

7,182 Bytes41,472 Bytes

Form: Certificate of Medical Necessity for Nebulizers (MC 4601)

12,058 Bytes52,736 Bytes

Form: Certificate of Medical Necessity for Oxygen (MC 4602)

30,925 Bytes126,464 Bytes

Durable Medical Equipment (DME): Bill for DME (dura bil)

27,253 Bytes111,616 Bytes

Durable Medical Equipment (DME): Bill for Wheelchairs and Wheelchair Accessories (dura bil wheel)

274,925 Bytes352,256 Bytes

Form: Certificate of Medical Necessity for a Manual Wheelchair, Standard or Custom (DHS 6181-A)

282,134 Bytes359,424 Bytes

Form: Certificate of Medical Necessity for a Motorized Wheelchair, Custom or Standard (DHS 6181-B)

249,872 Bytes330,240 Bytes

Form: Certificate of Medical Necessity for a Power Operated Vehicle (POV) aka Scooter, Standard or Bariatric (DHS 6181-C)

98,167 Bytes779,776 Bytes

Durable Medical Equipment (DME): Billing Codes and Reimbursement Rates (dura cd)

10,359 Bytes39,424 Bytes

Durable Medical Equipment (DME): Billing Codes for California Children's Services (CCS) (dura cd ccs)

23,317 Bytes109,056 Bytes

Durable Medical Equipment (DME) Billing Codes: Frequency Limits (dura cd fre)

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Durable Medical Equipment (DME): Billing Examples (dura ex)

19,696 Bytes75,776 Bytes

Durable Medical Equipment (DME): Infusion Equipment (dura inf)

59,105 Bytes246,784 Bytes

Durable Medical Equipment (DME): Other DME Equipment (dura other)

64,341 Bytes301,568 Bytes

Durable Medical Equipment (DME): Oxygen and Respiratory Equipment (dura oxy)

18,398 Bytes70,656 Bytes

Durable Medical Equipment (DME): Speech Generating Devices (SGD) (dura spe)

65,519 Bytes303,616 Bytes

Durable Medical Equipment (DME): Therapeutic Anti-Decubitus Mattresses and Bed Products (dura thp)

47,117 Bytes181,248 Bytes

Durable Medical Equipment (DME): Wheelchair and Wheelchair Accessories Guidelines (dura wheel guide)

37,209 Bytes168,960 Bytes

Enteral Nutrition Products (enteral)

13,843 Bytes43,520 Bytes

Forms: Legibility and Completion Standards (forms leg)

9,676 Bytes32,256 Bytes

Forms Reorder Request: Guidelines (forms reo)

146,795 Bytes278,528 Bytes

Forms Reorder Request: Medical Services and Allied Health (forms reo ma)

32,701 Bytes118,272 Bytes

Genetically Handicapped Persons Program (GHPP) (genetic)

11,392 Bytes40,960 Bytes

HCPCS Introduction (hcpcs)

10,880 Bytes54,272 Bytes

HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii)

31,746 Bytes119,296 Bytes

Incontinence Medical Supplies (incont)

449,806 Bytes521,216 Bytes

Incontinence Medical Supplies Example: CMS-1500 (incont ex)

11,442 Bytes44,544 Bytes

Intravenous or Intra-arterial Solutions: Administration Sets (iv sol admin)

30,615 Bytes119,296 Bytes

Medical Supplies (mc sup)

474,549 Bytes579,584 Bytes

Medical Supplies: Billing Examples (mc sup ex)

31,612 Bytes119,296 Bytes

Medicare/Medi-Cal Crossover Claims: CMS-1500 (medi cr cms)

462,308 Bytes531,456 Bytes

Medicare/Medi-Cal Crossover Claims: CMS-1500 Billing Examples for Allied Health (medi cr cms exa)

33,816 Bytes193,536 Bytes

Medicare/Medi-Cal Crossover Claims: CMS-1500 Pricing Examples for Allied Health (medi cr cms pra)

20,181 Bytes73,216 Bytes

Medicare/Medi-Cal Crossover Claims: UB-04 (medi cr ub)

198,834 Bytes265,728 Bytes

Medicare/Medi-Cal Crossover Claims: UB-04 Billing Examples (medi cr ub ex)

8,336 Bytes31,744 Bytes

Medicare Non-Covered Services: Charts Introduction (medi non cha)

15,577 Bytes63,488 Bytes

Medicare Non-Covered Services: HCPCS Codes (medi non hcp)

43,074 Bytes275,456 Bytes

Modifiers: Approved List (modif app)

28,207 Bytes115,200 Bytes

Optional Benefits Exclusion (opt ben exc)

64,841 Bytes525,824 Bytes

Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Orthotics (ortho cd1)

48,074 Bytes383,488 Bytes

Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Prosthetics (ortho cd2)

16,941 Bytes68,608 Bytes

Orthotics and Prosthetics: Frequency Limits for Orthotics (ortho cd fre1)

14,642 Bytes60,416 Bytes

Orthotics and Prosthetics: Frequency Limits for Prosthetics (ortho cd fre2)

16,821 Bytes59,904 Bytes

Other Health Coverage (OHC) (oth hlth)

12,367 Bytes44,032 Bytes

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)

12,139 Bytes40,448 Bytes

Remittance Advice Details (RAD) (remit adv)

26,600 Bytes166,912 Bytes

Remittance Advice Details (RAD) Examples: Allied Health and Medical Services (remit ex am)

10,686 Bytes35,328 Bytes

Remittance Advice Details (RAD): Payments and Claim Status (remit pay)

30,206 Bytes117,760 Bytes

Respiratory Care (respir)

626,283 Bytes734,208 Bytes

Share of Cost (SOC): CMS-1500 (share cms)

12,148 Bytes44,544 Bytes

Sign Language Interpretation (sign)

77,638 Bytes139,776 Bytes

TAR Completion (tar comp)

19,946 Bytes89,600 Bytes

TAR Criteria for NF Authorization (Valdivia v. Coye) (tar crit nf)

294,934 Bytes543,232 Bytes

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)

29,312 Bytes121,856 Bytes

TAR Field Office Addresses (tar field)

104,194 Bytes151,552 Bytes

TAR Submission: Transmittal Form (tar submis)

10,532 Bytes33,792 Bytes

TAR: Submitting Appeals (tar submit)

35,281 Bytes197,120 Bytes

Taxable and Non-Taxable Items (tax)



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