Claims Processing Issue for Local Per Visit Code 03

October 25, 2017

The Department of Health Care Services (DHCS) has identified a claims processing issue causing claims billed with local per visit code 03 (dental services) to erroneously deny with Remittance Advice Details (RAD) code 9272: Revenue code invalid for date of service or provider type. This issue impacts Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Indian Health Services-Memorandum of Agreement (IHS-MOAs) 638, Clinics, for claims submitted between October 1, 2017, and October 12, 2017. Claims erroneously denied with this RAD message will be reprocessed. Providers may continue to check the Medi-Cal website for further information.