Notice of HIPAA Code Conversion for NICU/PICU Services

February 6, 2019

The Neonatal and Pediatric Intensive Care Unit (NICU/PICU) code conversion replaces HCPCS Level III codes, commonly referred to as local codes, with HIPAA-compliant CPT national codes. HIPAA mandated these changes to the billing requirements for NICU/PICU services. Due to recent changes to the NICU/PICU services code conversion the policy effective date is now June 1, 2019.

For claims with dates of service on or after June 1, 2019, providers will use HIPAA-compliant CPT codes with or without modifier(s).

Billing Instructions and Frequently Asked Questions (FAQs) will soon be available in the NICU/PICU Services section of the HIPAA: Code Conversions web page. Additional information for this project will publish as details are determined.

Providers are encouraged to:

Providers may request additional onsite or telephone support via the Telephone Service Center (TSC) at 1-800-541-5555, from 8 a.m. to 5 p.m., Monday through Friday, except holidays. Border providers and out-of-state billers billing for in-state providers call (916) 636-1200. Providers calling from outside of California call the Out-of-State Provider Unit at (916) 636-1960.

For electronic claim submission questions, contact the TSC at 1-800-541-5555, select option 4 for the Technical Help Desk and option 2 for Computer Media Claims (CMC).

Email all other questions about the NICU/PICU code conversion to