Optional Benefits Excluded from Medi-Cal Coverage – Assembly Bill X3 5 (Evans, Chapter 20, Statutes of 2009), the budget trailer bill for the recently signed budget bill, added Section 14131.10 of the Welfare and Institutions Code (W&I Code) to exclude several optional benefits categories from coverage under the Medi-Cal program to be implemented on July 1, 2009.

2009 CPT-4/HCPCS Updates: Implementation September 1, 2009 – The 2009 updates to the Current Procedural Terminology – 4th Edition (CPT-4) and Healthcare Common Procedure Coding System (HCPCS) National Level II codes will be effective for Medi-Cal for dates of service on or after September 1, 2009.

Miscellaneous Medical Surgical Supplies Billing Code Conversion – Reminder – Effective for dates of service on or after August 1, 2009, the Department of Health Care Services (DHCS) will discontinue the use of the current Medi-Cal interim codes (HCPCS codes X1516, X1518 and X7704) related to certain miscellaneous medical surgical supplies.

Prosthetic Implants: Modifier Update – Reimbursement for HCPCS code L8699 (prosthetic implant, not otherwise specified) has expanded to include at least one non-bilateral service, spinal hardware.

Pulmonary Stress Testing and Echocardiography Codes Update – Effective for dates of service on or after July 1, 2009, providers can bill the following pulmonary and cardiology tests for reimbursement.

Sterilization Procedure and Consent Form Requirements Updates – Effective for dates of service on or after July 1, 2009, the minimum age requirement for CPT-4 code 58671 (laparoscopy, surgical; with occlusion of oviducts by device [eg, band, clip, or Falope ring]) is 21 years of age.

CCS Service Code Groupings Update – The following codes will be added to the California Children’s Services (CCS) Service Code Groupings (SCGs).

BCCTP Internet Medi-Cal Application Update – Effective June 22, 2009, additional recipient information will be required on the Breast and Cervical Cancer Treatment Program (BCCTP) Internet Medi-Cal Application Worksheet.

Outpatient Heroin Detoxification Billing Code Conversions Reminder – Effective for dates of service on or after September 1, 2009, the Department of Health Care Services (DHCS) will discontinue the use of the current Medi-Cal interim codes for outpatient heroin detoxification services.

List of Contract Blood Factors Created – Assembly Bill 1183, Chapter 758, Statutes of 2008, amended Welfare and Institutions Code (W&I Code) 14105.86 by adding the requirement for the Department of Health Care Services (DHCS) to collect a supplemental rebate on blood factors.

Authorized Drug Manufacturer Labeler Codes Update – The Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes section has been updated.

Medi-Cal List of Contract Drugs – The following provider manual sections have been updated: Drugs: Contract Drugs List Part 1 – Prescription Drugs, Drugs: Contract Drugs List Part 2 – Over-the-Counter Drugs and Drugs: Contract Drugs List Part 4 – Therapeutic Classifications Drugs.

Pages updated/corrected due to ongoing provider manual revisions:
Contents for General Medicine Billing and Policy iii thru vi
Getting Started: Where to Find the Answers C-1 thru C-4
genetic 3/4
non ph 9/10, 19/20
path blood 1 thru 6
path blood ex 1 thru 3
tar comp 9/10