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

Medi-Cal Logo
Click to Sign Up for MCSS emails

Issue Resolved: Erroneously Issued Resubmission Turnaround Documents

September 24, 2015

On July 31, 2015, Xerox State Healthcare, LLC (Xerox) resolved the system issue that caused some providers to receive an erroneous Resubmission Turnaround Document (RTD) (Form 65–1) with Remittance Advice Detail (RAD) code 0196: This procedure requires a modifier; modifier is not present. This error occurred for claims submitted with the following CPT-4 codes on or after June 22, 2015, until a solution was implemented on August 1, 2015:

CPT-4 Code Description
88141 Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician
92002 Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;

intermediate, new patient

92004 Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;

comprehensive, new patient, 1 or more visits

92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program;

Intermediate, established patient

92014 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program;

comprehensive, established patient, 1 or more visits

92015 Determination of refractive state
93000 Electrocardiogram, routine ECG with at least 12 leads;
93005

tracing only, without interpretation and report

93010

Interpretation and report only

Claims submitted on or after August 1, 2015, with the CPT-4 codes listed above did not receive the error and were processed correctly.

On August 19, 2015, Xerox began reprocessing the impacted claims that generated an erroneous RTD. Providers can expect to see these claims reflected on their warrants beginning August 24, 2015. Additionally, claims for which providers responded to the RTDs and received a denial will be reprocessed in an upcoming Erroneous Payment Correction (EPC).