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Erroneously Denied Ophthalmology Claims Will Be Reprocessed

September 20, 2016

The Department of Health Care Services (DHCS) identified a claims processing issue causing some claims billed with ophthalmology codes to erroneously deny. This issue affects claims for dates of service on or after October 1, 2015. DHCS will notify providers when the issue is resolved. Affected claims will be reprocessed via an Erroneous Payment Correction (EPC). Providers should continue to submit claims in a timely manner and are encouraged to check the Medi-Cal website regularly for updates regarding this issue.