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2017 ICD-10-CM Code Update for Contraceptive-Related Services

October 17, 2016

A NewsFlash article published on August 31, 2016, titled, “2017 ICD-10-CM Diagnosis Code Update,” notified providers that effective for dates of service on or after October 1, 2016, the Centers for Medicare & Medicaid Services (CMS) updated the ICD-10-CM diagnosis codes for the 2017 ICD-10-CM annual update. Providers are required to use the new ICD-10-CM codes as of October 1, 2016.

Under Medi-Cal, claims submitted using the new 2017 ICD-10-CM family planning codes will be processed as the codes become available in the claims processing system. For Family Planning, Access, Care and Treatment (Family PACT) Program claims, the system was not updated in time for the October 1, 2016, effective date. Claims for HCPCS code J7303 (vaginal ring), J7304 (transdermal patch) and CPT-4 code 57170 (diaphragm or cervical cap fitting) submitted with the ICD-10-CM code for surveillance encounters may be impacted and claims may be denied.

An Erroneous Payment Correction (EPC) will be implemented to reprocess any erroneous denials for Family PACT claims submitted with dates of service between October 1, 2016, and implementation of the 2017 ICD-10-CM codes. Providers should continue to submit claims in a timely manner.