Providers are reminded that claims for surgical implants must be submitted with a manufacturer or distributor invoice.

The following documentation is required on the invoice or on another attachment to the claim:

• The invoice must be produced by the manufacturer or distributor and contain their name and address.
• The hospital must add the patient’s full name and Medi-Cal recipient number, name of the physician, name of the facility, the date of the surgical implant procedure to the manufacturer or distributor invoice and/or the attachments to the invoice.

The following will result in denied claims:

• Failure to submit manufacturer or distributor invoices with claims for surgical implantable devices
• Claims submitted with a hospital invoice or purchase order
• Claims submitted with a catalog page

This information is reflected on manual replacement page surg 6 (Part 2).