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

9,015 Bytes30,208 Bytes

Manual Organization (0Amanorg)

23,816 Bytes86,016 Bytes

How to Use This Manual (0Bhwtouse)

21,648 Bytes82,944 Bytes

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

17,706 Bytes63,488 Bytes

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

20,594 Bytes72,704 Bytes

Abortions (abort)

14,094 Bytes48,128 Bytes

Alternative Birthing Centers (altern)

41,212 Bytes159,232 Bytes

Anesthesia (anest)

724,158 Bytes844,288 Bytes

Anesthesia Billing Examples: CMS-1500 (anest cms)

112,485 Bytes166,400 Bytes

Appeal Form Completion (appeal form)

15,572 Bytes53,248 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)

458,832 Bytes524,800 Bytes

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

9,952 Bytes40,448 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)

16,877 Bytes55,808 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)

27,850 Bytes101,376 Bytes

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

67,694 Bytes300,032 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)

10,211 Bytes36,864 Bytes

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

130,860 Bytes226,816 Bytes

CIF Completion (cif co)

103,149 Bytes162,304 Bytes

CIF Special Billing Instructions (cif sp)

64,864 Bytes100,864 Bytes

CIF Submission and Timeliness Instructions (cif sub)

565,731 Bytes722,432 Bytes

CMS-1500 Completion (cms comp)

196,368 Bytes261,632 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)

74,413 Bytes119,296 Bytes

Contracted Inpatient Services for Medical Services (cont ms)

17,679 Bytes70,144 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)

22,022 Bytes80,384 Bytes

Drug Use Review (DUR) Program (drug)

54,754 Bytes613,888 Bytes

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

46,172 Bytes189,440 Bytes

Evaluation & Management (E&M) (eval)

2,005,534 Bytes2,383,360 Bytes

Every Woman Counts (ev woman)

413,173 Bytes480,768 Bytes

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

45,083 Bytes208,384 Bytes

Family Planning (fam planning)

446,076 Bytes517,120 Bytes

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

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)

18,251 Bytes58,880 Bytes

Genetic Counseling and Screening (gene coun)

450,589 Bytes516,608 Bytes

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

30,815 Bytes112,640 Bytes

Genetically Handicapped Persons Program (GHPP) (genetic)

14,749 Bytes51,200 Bytes

HCPCS Introduction (hcpcs)

10,838 Bytes57,856 Bytes

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

22,878 Bytes99,840 Bytes

Hysterectomy (hyst)

37,195 Bytes142,336 Bytes

Immunizations (immun)

11,572 Bytes37,376 Bytes

Immunizations Code List (immun cd)

16,988 Bytes67,584 Bytes

Injections: An Overview (inject an over)

461,023 Bytes528,384 Bytes

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

35,520 Bytes121,344 Bytes

Injections: Code List (inject cd list)

65,131 Bytes245,248 Bytes

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

59,136 Bytes232,448 Bytes

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

41,709 Bytes155,648 Bytes

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

37,206 Bytes136,704 Bytes

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

41,696 Bytes156,160 Bytes

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

9,650 Bytes38,400 Bytes

Injections: Hydration (inject hydra)

31,225 Bytes118,272 Bytes

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

1,427,608 Bytes1,592,320 Bytes

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

33,466 Bytes194,560 Bytes

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

7,951 Bytes26,624 Bytes

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

11,004 Bytes48,128 Bytes

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

15,653 Bytes65,536 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)

13,511 Bytes57,344 Bytes

Minor Consent Program (minor)

11,040 Bytes36,352 Bytes

Modifiers (modif)

39,357 Bytes258,560 Bytes

Modifiers: Approved List (modif app)

26,305 Bytes131,072 Bytes

Modifiers Used With Procedure Codes (modif used)

29,616 Bytes109,568 Bytes

Non-Injectable Drugs (non inject)

55,687 Bytes342,016 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)

14,282 Bytes49,664 Bytes

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

33,168 Bytes132,608 Bytes

Optional Benefits Exclusion (opt ben exc)

16,266 Bytes54,784 Bytes

Other Health Coverage (OHC) (oth hlth)

12,701 Bytes49,152 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)

34,571 Bytes122,368 Bytes

Pathology: Billing and Modifiers (path bil)

96,630 Bytes131,072 Bytes

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

11,384 Bytes39,424 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)

26,344 Bytes139,776 Bytes

Pathology: Chemistry (path chem)

14,197 Bytes52,224 Bytes

Pathology: Cytopathology (path cyto)

14,864 Bytes48,128 Bytes

Pathology: Drug Testing (path drug)

12,292 Bytes44,032 Bytes

Pathology: Immunology (path immun)

25,461 Bytes107,520 Bytes

Pathology: Microbiology (path micro)

74,001 Bytes483,328 Bytes

Pathology: Molecular Pathology (path molec)

17,856 Bytes71,680 Bytes

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

13,820 Bytes46,592 Bytes

Pathology: Surgical (path surg)

9,873 Bytes33,792 Bytes

Pathology: Urinalysis (path urin)

15,656 Bytes54,272 Bytes

Physician-Administered Drugs: NDC (physician ndc)

93,506 Bytes131,584 Bytes

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

22,163 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)

33,866 Bytes134,656 Bytes

Pregnancy: Early Care and Diagnostic Services (preg early)

2,036,856 Bytes2,298,880 Bytes

Pregnancy Examples: CMS-1500 (preg ex cms)

11,368 Bytes37,888 Bytes

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

12,312 Bytes40,960 Bytes

Pregnancy: Global Billing (preg glo)

7,837 Bytes46,592 Bytes

Pregnancy: Global Billing Codes (preg glo cd)

10,144 Bytes33,792 Bytes

Pregnancy: Per-Visit Billing (preg per)

8,643 Bytes30,208 Bytes

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

15,072 Bytes50,176 Bytes

Pregnancy: Postpartum and Newborn Referral Services (preg post)

7,356 Bytes45,056 Bytes

Pregnancy: Share of Cost (preg share)

21,221 Bytes73,728 Bytes

Presumptive Eligibility for Pregnant Women (presum)

28,145 Bytes98,304 Bytes

Presumptive Eligibility for Pregnant Women: Billing Codes (presum bill)

28,145 Bytes30,720 Bytes

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

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)

17,006 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)

17,978 Bytes63,488 Bytes

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

10,006 Bytes36,352 Bytes

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

12,367 Bytes44,032 Bytes

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

21,551 Bytes81,408 Bytes

Radiology (radi)

886,842 Bytes996,864 Bytes

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

50,085 Bytes204,288 Bytes

Radiology: Diagnostic (radi dia)

15,131 Bytes56,320 Bytes

Radiology: Diagnostic Ultrasound (radi dia ult)

19,593 Bytes78,848 Bytes

Radiology: Nuclear Medicine (radi nuc)

23,770 Bytes84,480 Bytes

Radiology: Oncology (radi onc)

19,741 Bytes75,264 Bytes

Rates: Maximum Reimbursement (rates max)

8,410 Bytes29,184 Bytes

Rates: Maximum Reimbursement for Laboratories (rates max lab)

12,139 Bytes40,448 Bytes

Remittance Advice Details (RAD) (remit adv)

25,207 Bytes159,744 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)

626,283 Bytes734,208 Bytes

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

12,148 Bytes44,544 Bytes

Sign Language Interpretation (sign)

1,715,786 Bytes1,876,480 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)

18,272 Bytes65,024 Bytes

Surgery (surg)

881,232 Bytes1,019,904 Bytes

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

21,021 Bytes74,240 Bytes

Surgery: Billing With Modifiers (surg bil mod)

11,306 Bytes37,376 Bytes

Surgery: Female Genital System (surg female)

7,821 Bytes27,648 Bytes

Surgery: Laparoscopy and Hysteroscopy (surg lap)

8,719 Bytes30,208 Bytes

Surgery: Male Genital System (surg male)

17,892 Bytes62,976 Bytes

Surgery: Urinary System (surg urin)

8,372 Bytes27,648 Bytes

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

17,245 Bytes70,144 Bytes

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

21,560 Bytes85,504 Bytes

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

27,677 Bytes113,664 Bytes

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

25,720 Bytes107,520 Bytes

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

25,026 Bytes98,304 Bytes

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

22,696 Bytes89,088 Bytes

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

12,930 Bytes48,128 Bytes

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

18,999 Bytes67,584 Bytes

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

31,574 Bytes119,808 Bytes

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

77,141 Bytes138,240 Bytes

TAR Completion (tar comp)

294,934 Bytes543,232 Bytes

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

29,977 Bytes124,416 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)

9,534 Bytes32,768 Bytes

Transgender Services (transgender)

10,932 Bytes35,328 Bytes

Tuberculosis Program (tuber)

30,622 Bytes128,512 Bytes

Vaccines For Children (VFC) Program (vaccine)



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