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Medi-Cal Update

Vision Care | May 2021 | Bulletin 520

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1. New NDC for Moderna COVID-19 Vaccine

Moderna has introduced a new National Drug Code (NDC), 80777027315, for their coronavirus disease 2019 (COVID-19) vaccine. Medi-Cal will accept and adjudicate pharmacy claims for dates of service on or after April 1, 2021, that use this NDC when billing for the administration of either dose of the Moderna COVID-19 vaccine.

The Moderna COVID-19 Vaccine web page is updated to reflect this change. All other billing policy, regardless of NDC billed, remains unchanged.

2. CCS Service Code Groupings Policy Update

The following codes will be added to or end-dated from the California Children's Services (CCS) Service Code Groupings (SCGs):

Added Codes

Effective Date Codes SCGs
January 1, 2021 Proprietary Laboratory Analyses (PLA) codes 0001A, 0002A, 0011A, 0012A and 0031A 01, 02
January 1, 2021 CPT® codes 94726 and 94729 01
January 1, 2021 CPT code 92523 05

End-Dated Codes

Effective Date CPT Codes SCGs
January 1, 2021 76970, 78135, 94250, 94400, 94750 and 94770 01
January 1, 2021 32405 and 81545 02
January 1, 2021 92585 and 92586 01, 04, 05, 06

Reminder:

SCG 02 includes all the codes in SCG 01, plus additional codes applicable only to SCG 02. SCG 03 includes all the codes in SCG 01 and SCG 02, plus additional codes applicable only to SCG 03. SCG 07 includes all the codes in SCG 01 plus additional codes applicable only to SCG 07.

Provider Manual(s) Page(s) Updated
Audiology and Hearing Aids
Chronic Dialysis Clinics
Clinics and Hospitals
Durable Medical Equipment
General Medicine
Home Health Agencies/Home and Community-Based Services
Inpatient Services
Local Educational Agency
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
Vision Care
cal child ser (6, 14, 23, 24, 28, 32, 34, 36, 37)

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4. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:



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