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Claims Issue for Contraceptive Rings and Patches

September 5, 2019

The Department of Health Care Services (DHCS) has identified a claims processing issue causing Family Planning, Access, Care and Treatment (Family PACT) Program claims for HCPCS code J7303 (contraceptive vaginal ring) and J7304 (contraceptive transdermal patch) to erroneously deny with Remittance Advice Details (RAD) code 9942: NCCI (National Correct Coding Initiative) quantity billed is greater than the allowed MUE (Medically Unlikely Edit) quantity.

DHCS and the California Medicaid Management Information System (MMIS) Fiscal Intermediary (FI) are working to resolve this issue. 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.