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

Part 2 – Obstetrics (OB)

106,894 Bytes206,336 Bytes

Medi-Cal Program (00medi-cal)

3,922 Bytes22,016 Bytes

Medi-Cal Provider Manual Contents

7,265 Bytes49,152 Bytes

Manual Organization (0Amanorg)

22,227 Bytes84,992 Bytes

How to Use This Manual (0Bhwtouse)

19,786 Bytes80,384 Bytes

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

16,744 Bytes66,048 Bytes

Contents (Part 2 – Medi-Cal Billing and Policy): Obstetrics (OB) (2toc ob)

18,444 Bytes69,120 Bytes

Abortions (abort)

12,679 Bytes43,520 Bytes

Alternative Birthing Centers (altern)

36,083 Bytes150,528 Bytes

Anesthesia (anest)

721,097 Bytes841,216 Bytes

Anesthesia Billing Examples: CMS-1500 (anest cms)

110,276 Bytes161,792 Bytes

Appeal Form Completion (appeal form)

15,469 Bytes51,712 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)

6,830 Bytes35,328 Bytes

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

458,832 Bytes524,800 Bytes

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

6,747 Bytes38,912 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)

10,560 Bytes49,664 Bytes

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)

36,132 Bytes67,072 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)

23,827 Bytes94,208 Bytes

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

66,879 Bytes322,560 Bytes

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

4,199 Bytes26,624 Bytes

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

106,270 Bytes155,648 Bytes

Child Health and Disability Prevention (CHDP) Program (child)

125,697 Bytes212,992 Bytes

CIF Completion (cif co)

101,943 Bytes161,792 Bytes

CIF Special Billing Instructions (cif sp)

63,483 Bytes100,352 Bytes

CIF Submission and Timeliness Instructions (cif sub)

558,721 Bytes710,144 Bytes

CMS-1500 Completion (cms comp)

193,373 Bytes253,440 Bytes

CMS-1500 Special Billing Instructions (cms spec)

17,802 Bytes76,288 Bytes

CMS-1500 Submission and Timeliness Instructions (cms sub)

11,087 Bytes68,096 Bytes

CMS-1500 Tips for Billing (cms tips)

75,955 Bytes128,512 Bytes

Contracted Inpatient Services for Medical Services (cont ms)

17,209 Bytes68,096 Bytes

Correct Coding Initiative: National (correct)

132,668 Bytes173,568 Bytes

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

7,193 Bytes26,112 Bytes

Dental Benefits (dental)

21,964 Bytes79,872 Bytes

Drug Use Review (DUR) Program (drug)

55,491 Bytes602,112 Bytes

Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5)

40,616 Bytes165,376 Bytes

Evaluation & Management (E&M) (eval)

51,505 Bytes257,024 Bytes

Every Woman Counts (ev woman)

413,173 Bytes480,768 Bytes

Every Woman Counts Billing Examples: CMS-1500 (ev woman exc)

22,948 Bytes81,920 Bytes

Family Planning (fam planning)

446,076 Bytes517,120 Bytes

Family Planning Billing Example: CMS-1500 (fam planning cms)

13,404 Bytes43,520 Bytes

Forms: Legibility and Completion Standards (forms leg)

9,276 Bytes31,744 Bytes

Forms Reorder Request: Guidelines (forms reo)

30,633 Bytes64,512 Bytes

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

17,635 Bytes59,392 Bytes

Genetic Counseling and Screening (gene coun)

449,769 Bytes517,120 Bytes

Genetic Disease Screening Billing Examples: CMS-1500 (gene ex)

29,644 Bytes113,664 Bytes

Genetically Handicapped Persons Program (GHPP) (genetic)

9,899 Bytes32,768 Bytes

HCPCS Introduction (hcpcs)

11,603 Bytes59,904 Bytes

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

18,712 Bytes90,112 Bytes

Hysterectomy (hyst)

34,389 Bytes140,288 Bytes

Immunizations (immun)

10,963 Bytes37,376 Bytes

Immunizations Code List (immun cd)

15,990 Bytes67,072 Bytes

Injections: An Overview (inject an over)

461,023 Bytes528,384 Bytes

Injections: Billing Example for CMS-1500 (inject bil cms)

29,758 Bytes105,984 Bytes

Injections: Code List (inject cd list)

45,950 Bytes185,856 Bytes

Injections: Drugs A-D Policy (inject drug a-d)

46,189 Bytes181,248 Bytes

Injections: Drugs E-H Policy (inject drug e-h)

31,349 Bytes122,880 Bytes

Injections: Drugs I-M Policy (inject drug i-m)

31,706 Bytes111,104 Bytes

Injections: Drugs N-R Policy (inject drug n-r)

35,072 Bytes128,000 Bytes

Injections: Drugs S-Z Policy (inject drug s-z)

6,843 Bytes38,912 Bytes

Injections: Hydration (inject hydra)

28,965 Bytes109,568 Bytes

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

460,117 Bytes526,848 Bytes

Medicare/Medi-Cal Crossover Claims: CMS-1500 Billing Examples for Medical Services (medi cr cms exm)

30,851 Bytes194,560 Bytes

Medicare/Medi-Cal Crossover Claims: CMS-1500 Pricing Examples for Medical Services (medi cr cms prm)

4,725 Bytes29,696 Bytes

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

9,967 Bytes45,568 Bytes

Medicare Non-Covered Services: CPT-4 Codes (medi non cpt)

14,943 Bytes68,608 Bytes

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

4,205 Bytes28,672 Bytes

Medicare Procedures: Medi-Cal Code Correlation List (medi pro med)

12,779 Bytes57,344 Bytes

Minor Consent Program (minor)

10,719 Bytes35,328 Bytes

Modifiers (modif)

34,319 Bytes252,928 Bytes

Modifiers: Approved List (modif app)

22,632 Bytes117,248 Bytes

Modifiers Used With Procedure Codes (modif used)

20,868 Bytes73,728 Bytes

Non-Injectable Drugs (non inject)

48,837 Bytes296,960 Bytes

Non-Physician Medical Practitioners (NMP) (non ph)

445,113 Bytes509,952 Bytes

Non-Physician Medical Practitioners (NMP) Billing Example: CMS-1500 (non ph cms)

13,101 Bytes46,080 Bytes

Once-in-a-Lifetime Procedure Codes (once)

31,148 Bytes132,608 Bytes

Optional Benefits Exclusion (opt ben exc)

14,889 Bytes52,736 Bytes

Other Health Coverage (OHC) (oth hlth)

11,907 Bytes48,640 Bytes

Other Health Coverage (OHC): CPT-4 and HCPCS Codes (oth hlth cpt)

20,838 Bytes79,360 Bytes

Pathology: An Overview of Enrollment and Proficiency Testing Requirements (path an over)

32,727 Bytes115,200 Bytes

Pathology: Billing and Modifiers (path bil)

96,630 Bytes131,072 Bytes

Pathology Billing Example: CMS-1500 (path bil cms)

12,720 Bytes45,568 Bytes

Pathology: Blood Collection and Handling (path blood)

447,639 Bytes512,000 Bytes

Pathology: Blood Collection and Handling Billing Examples: CMS-1500 (path blood ex)

23,609 Bytes128,512 Bytes

Pathology: Chemistry (path chem)

14,292 Bytes52,224 Bytes

Pathology: Cytopathology (path cyto)

14,454 Bytes46,080 Bytes

Pathology: Drug Testing (path drug)

12,292 Bytes44,032 Bytes

Pathology: Immunology (path immun)

22,390 Bytes96,256 Bytes

Pathology: Microbiology (path micro)

52,050 Bytes316,416 Bytes

Pathology: Molecular Pathology (path molec)

16,423 Bytes69,120 Bytes

Pathology: Organ or Disease-Oriented Panels (path organ)

13,708 Bytes46,592 Bytes

Pathology: Surgical (path surg)

9,873 Bytes33,792 Bytes

Pathology: Urinalysis (path urin)

11,654 Bytes39,936 Bytes

Physician-Administered Drugs: NDC (physician ndc)

93,506 Bytes131,584 Bytes

Physician-Administered Drugs – NDC: CMS-1500 Billing Instructions (physician ndc cms)

21,283 Bytes80,384 Bytes

Pregnancy: Comprehensive Perinatal Services Program (CPSP) (preg com)

797,252 Bytes915,968 Bytes

Pregnancy: Comprehensive Perinatal Services Program (CPSP) Billing Examples - CMS-1500 (preg com exc)

10,745 Bytes38,912 Bytes

Pregnancy: Comprehensive Perinatal Services Program (CPSP) List of Billing Codes (preg com lis)

8,140 Bytes28,160 Bytes

Pregnancy Determination (preg determ)

30,947 Bytes137,216 Bytes

Pregnancy: Early Care and Diagnostic Services (preg early)

2,036,856 Bytes2,298,880 Bytes

Pregnancy Examples: CMS-1500 (preg ex cms)

11,286 Bytes37,888 Bytes

Pregnancy: Fetal Monitoring, Labor and Delivery Services (preg fetal)

11,747 Bytes40,960 Bytes

Pregnancy: Global Billing (preg glo)

7,837 Bytes46,592 Bytes

Pregnancy: Global Billing Codes (preg glo cd)

9,787 Bytes33,280 Bytes

Pregnancy: Per-Visit Billing (preg per)

8,643 Bytes30,208 Bytes

Pregnancy: Per-Visit Billing Codes (preg per cd)

13,212 Bytes46,592 Bytes

Pregnancy: Postpartum and Newborn Referral Services (preg post)

7,356 Bytes45,056 Bytes

Pregnancy: Share of Cost (preg share)

38,187 Bytes136,704 Bytes

Presumptive Eligibility for Pregnant Women (presum)

9,494 Bytes30,720 Bytes

Form: Presumptive Eligibility for Pregnant Women Provider Fact Sheet (presumb prv fact)

12,668 Bytes40,448 Bytes

Form: Directions to Apply for Medi-Cal (presum cdir app)

10,186 Bytes37,376 Bytes

Form: Form Order Presumptive Eligibility (PE) For Pregnant Women Program (presumdfmordr)

7,565 Bytes25,600 Bytes

Form: Patient Directions For Presumptive Eligibility For Pregnant Women Program Application (presum e pat dir)

5,385 Bytes37,376 Bytes

Form: Instrucciones para el Paciente para la Solicitud de Elegibilidad Presunta

10,177 Bytes33,280 Bytes

Presumptive Eligibility for Pregnant Women Program Patient Fact Sheet (presumfpatfact)

17,006 Bytes77,824 Bytes

Presumptive Eligibility for Pregnant Women Program Patient Fact Sheet (MC 264) (Spanish)

10,578 Bytes38,400 Bytes

Form: Statement of California Residency (presumireside)

5,528 Bytes27,136 Bytes

Form: Declaracion de Residencia en California

8,419 Bytes27,648 Bytes

Form: Explanation of Ineligibility For The Presumptive Eligibility For Pregnant Women Program (presumjnobene)

21,167 Bytes82,432 Bytes

Presumptive Eligibility for Pregnant Women Program Process (presum proc)

17,507 Bytes65,024 Bytes

Presumptive Eligibility for Pregnant Women Provider Enrollment Instructions (presum prov)

10,170 Bytes37,888 Bytes

Presumptive Eligibility for Pregnant Women Provider Enrollment Checklist (presum prov enroll frm)

11,108 Bytes56,832 Bytes

Form: Weekly Presumptive Eligibility (PE) For Pregnant Women Enrollment Summary MC 283 (presum week summ)

11,854 Bytes43,520 Bytes

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

19,930 Bytes79,360 Bytes

Radiology (radi)

884,423 Bytes996,864 Bytes

Radiology Billing Example: CMS-1500 (radi bil cms)

48,011 Bytes202,240 Bytes

Radiology: Diagnostic (radi dia)

13,031 Bytes51,200 Bytes

Radiology: Diagnostic Ultrasound (radi dia ult)

18,445 Bytes77,312 Bytes

Radiology: Nuclear Medicine (radi nuc)

22,858 Bytes85,504 Bytes

Radiology: Oncology (radi onc)

18,545 Bytes77,824 Bytes

Rates: Maximum Reimbursement (rates max)

8,410 Bytes29,184 Bytes

Rates: Maximum Reimbursement for Laboratories (rates max lab)

10,070 Bytes52,224 Bytes

Remittance Advice Details (RAD) (remit adv)

25,018 Bytes159,232 Bytes

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

10,322 Bytes35,328 Bytes

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

690,784 Bytes803,328 Bytes

Resubmission Turnaround Document (RTD) Completion (resub comp)

626,283 Bytes734,208 Bytes

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

11,715 Bytes45,056 Bytes

Sign Language Interpretation (sign)

1,259,745 Bytes1,418,752 Bytes

Sterilization (ster)

10,513 Bytes34,816 Bytes

Supplies and Drugs (supp drug)

8,026 Bytes27,648 Bytes

Supplies and Drugs for Medical Services (supp drug ms)

18,672 Bytes67,584 Bytes

Surgery (surg)

733,025 Bytes846,336 Bytes

Surgery Billing Examples: CMS-1500 (surg bil cms)

18,389 Bytes68,096 Bytes

Surgery: Billing With Modifiers (surg bil mod)

10,796 Bytes36,352 Bytes

Surgery: Female Genital System (surg female)

4,694 Bytes35,840 Bytes

Surgery: Laparoscopy and Hysteroscopy (surg lap)

8,556 Bytes29,184 Bytes

Surgery: Male Genital System (surg male)

15,402 Bytes55,808 Bytes

Surgery: Urinary System (surg urin)

8,056 Bytes27,648 Bytes

TAR and Non-Benefit: Introduction to List (tar and non)

15,908 Bytes66,048 Bytes

TAR and Non-Benefit List: Codes 10000 – 19999 (tar and non cd1)

20,046 Bytes85,504 Bytes

TAR and Non-Benefit List: Codes 20000 – 29999 (tar and non cd2)

24,211 Bytes101,888 Bytes

TAR and Non-Benefit List: Codes 30000 – 39999 (tar and non cd3)

24,315 Bytes108,032 Bytes

TAR and Non-Benefit List: Codes 40000 – 49999 (tar and non cd4)

23,043 Bytes98,304 Bytes

TAR and Non-Benefit List: Codes 50000 – 59999 (tar and non cd5)

20,991 Bytes86,528 Bytes

TAR and Non-Benefit List: Codes 60000 – 69999 (tar and non cd6)

12,449 Bytes46,080 Bytes

TAR and Non-Benefit List: Codes 70000 – 79999 (tar and non cd7)

16,087 Bytes56,320 Bytes

TAR and Non-Benefit List: Codes 80000 – 89999 (tar and non cd8)

26,627 Bytes104,960 Bytes

TAR and Non-Benefit List: Codes 90000 – 99999 (tar and non cd9)

122,667 Bytes191,488 Bytes

TAR Completion (tar comp)

294,934 Bytes543,232 Bytes

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

27,549 Bytes122,368 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)

10,932 Bytes35,328 Bytes

Tuberculosis Program (tuber)

28,784 Bytes128,000 Bytes

Vaccines For Children (VFC) Program (vaccine)



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