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Claims Processing Issue for Hydroxyprogesterone Caproate Injection, Makena

December 4, 2017

The Department of Health Care Services (DHCS) has identified a claims processing issue causing claims billed with HCPCS code Q9986 (injection, hydroxyprogesterone caproate [Makena], 10 mg) to erroneously deny.

DHCS and the DHCS Fiscal Intermediary (FI) are working to resolve this issue. Impacted providers should continue to resubmit or appeal denied claims with proper documentation for timely processing and check for updates regarding this issue on the Medi-Cal website.