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Medi-Cal Update

Vision Care | March 2022 | Bulletin 530

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1. Changes to National Correct Coding Initiative January 2022 First Quarter Update

The Centers for Medicare & Medicaid Services (CMS) issued a third set of replacement files for National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits for the first quarter of 2022. The mandatory national edits were incorporated into the Medi-Cal claims processing system and were effective for claims received on or after January 1, 2022.

No action is required by providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess the affected claims, including those that were appropriately submitted based on the guidance published in this article, but erroneously adjudicated because Medi-Cal had not yet implemented the system changes to support appropriate adjudication.

More information on NCCI and this latest update can be found on The National Correct Coding Initiative in Medicaid web page.

2. National Correct Coding Initiative Quarterly Update for March 2022

The Centers for Medicare & Medicaid Services (CMS) has released the quarterly National Correct Coding Initiative (NCCI) payment policy updates. These mandatory national edits have been incorporated into the Medi-Cal claims processing system and are effective for claims received on or after April 1, 2022.

For additional information, refer to The National Correct Coding Initiative in Medicaid page of the Medicaid website.

3. June Virtual Claims Assistance Room (CAR) Room Event

Receive free one-on-one billing assistance at our Virtual Claims Assistance Room (CAR) event scheduled for the month of June.

There are multiple morning and afternoon sessions available. Providers must register through the Medi Cal Learning Portal Event Calendar.

Reminder: First time users must complete a one-time registration. Registration directions for these sessions are in a short video in the descriptive text under the “Provider Seminars and Webinars” tile on the Medi-Cal Learning Portal homepage.

Providers are encouraged to bring their more complex billing issues to a Provider Field Representative for individual assistance.

For additional assistance, please contact the Telephone Service Center (TSC) at 1-800-541-5555.

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