Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Part 2 – Chronic Dialysis Clinics (DIA)

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Medi-Cal Program (00medi-cal)

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Medi-Cal Provider Manual Contents

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Manual Organization (0Amanorg)

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How to Use This Manual (0Bhwtouse)

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Getting Started: Where to Find the Answers (0C get start)

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Contents (Part 2 – Medi-Cal Billing and Policy): Chronic Dialysis Clinics (2toc dia)

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Appeal Form Completion (appeal form)

23,812 Bytes87,552 Bytes

Blood and Blood Derivatives (blood)

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Blood and Blood Derivatives Billing Examples: UB-04 (blood ub)

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California Children's Services (CCS) Program (cal child)

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California Children’s Services (CCS) Program Approved Hospitals (cal child appr)

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California Children's Services (CCS) Program Billing (cal child bil)

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CCS Program Billing Guidelines (cal child bil guide)

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California Children's Services (CCS) Program Billing Example: UB-04 Claim Form (cal child bil ub)

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California Children’s Services (CCS) Program County Office Directory (cal child county)

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California Children's Services (CCS) Program Eligibility (cal child elig)

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California Children's Services (CCS) Program Medical Therapy Program (cal child med)

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California Children's Services (CCS) Program Provider Paneling (cal child panel)

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Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Physicians and Podiatrists (DHS 4514)

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Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Allied Health Care Professionals (DHS 4515 )

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California Children's Services (CCS) Program Referrals (cal child ref)

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California Children's Services (CCS) Program Service Authorization Request (SAR) (cal child sar)

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California Children’s Services (CCS) Program Service Code Groupings (cal child ser)

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California Children’s Services (CCS) Program Special Care Centers (cal child spec)

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CIF Completion (cif co)

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CIF Special Billing Instructions for Outpatient Services (cif sp op)

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CIF Submission and Timeliness Instructions (cif sub)

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Correct Coding Initiative: National (correct)

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Correct Coding Initiative: National – Claim Preparation (correct cod)

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Dialysis: Chronic Dialysis Services (dial chr)

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Dialysis: End Stage Renal Disease Services (dial end)

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Dialysis Examples: UB-04 (dial ex ub)

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Drugs: Contract Drugs List Part 5 – Authorized Manufacturer Labeler Codes (drugs cdl p5)

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Forms: Legibility and Completion Standards (forms leg)

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Forms Reorder Request: Guidelines (forms reo)

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Forms Reorder Request: Inpatient and Outpatient Services (forms reo io)

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Genetically Handicapped Persons Program (GHPP) (genetic)

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HCPCS Introduction (hcpcs)

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HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii)

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Immunizations (immun)

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Immunizations Code List (immun cd)

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Injections: An Overview (inject an over)

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Injections: Billing Example for UB-04 (inject bil ub)

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Injections: Code List (inject cd list)

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Injections: Drugs A-D Policy (inject drug a-d)

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Injections: Drugs E-H Policy (inject drug e-h)

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Injections: Drugs I-M Policy (inject drug i-m)

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Injections: Drugs N-R Policy (inject drug n-r)

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Injections: Drugs S-Z Policy (inject drug s-z)

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Injections: Hydration (inject hydra)

41,125 Bytes163,328 Bytes

Medicare/Medi-Cal Crossover Claims: Outpatient Services (medi cr op)

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Medicare/Medi-Cal Crossover Claims: Outpatient Services Billing Examples (medi cr op ex)

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Medicare/Medi-Cal Crossover Claims: Outpatient Services Medi-Cal Pricing Examples (medi cr op pr)

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Medicare Non-Covered Services: Charts Introduction (medi non cha)

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Medicare Non-Covered Services: CPT-4 Codes (medi non cpt)

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Medicare Non-Covered Services: HCPCS Codes (medi non hcp)

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Modifiers (modif)

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Modifiers: Approved List (modif app)

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Modifiers Used With Procedure Codes (modif used)

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Non-Injectable Drugs (non inject)

16,266 Bytes54,784 Bytes

Other Health Coverage (OHC) (oth hlth)

12,701 Bytes49,152 Bytes

Other Health Coverage (OHC): CPT-4 and HCPCS Codes (oth hlth cpt)

20,838 Bytes79,360 Bytes

Pathology: An Overview of Enrollment and Proficiency Testing Requirements (path an over)

33,210 Bytes124,928 Bytes

Pathology: Billing and Modifiers (path bil)

106,845 Bytes159,232 Bytes

Pathology Billing Examples: UB-04 (path bil ub)

13,330 Bytes45,568 Bytes

Pathology: Blood Collection and Handling (path blood)

25,924 Bytes139,264 Bytes

Pathology: Chemistry (path chem)

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Pathology: Cytopathology (path cyto)

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Pathology: Organ or Disease-Oriented Panels (path organ)

15,656 Bytes54,272 Bytes

Physician-Administered Drugs: NDC (physician ndc)

18,357 Bytes58,880 Bytes

Physician-Administered Drugs – NDC: UB-04 Billing Instructions (physician ndc ub)

12,367 Bytes44,032 Bytes

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)

12,139 Bytes40,448 Bytes

Remittance Advice Details (RAD) (remit adv)

28,367 Bytes174,592 Bytes

Remittance Advice Details (RAD) Examples: Outpatient Services (remit ex op)

10,686 Bytes35,328 Bytes

Remittance Advice Details (RAD): Payments and Claim Status (remit pay)

109,943 Bytes166,400 Bytes

Share of Cost (SOC): UB-04 for Outpatient Services (share op)

12,148 Bytes44,544 Bytes

Sign Language Interpretation (sign)

10,613 Bytes34,816 Bytes

Supplies and Drugs (supp drug)

51,716 Bytes83,968 Bytes

Supplies and Drugs Billing Examples: UB-04 (supp drug bil)

11,372 Bytes39,936 Bytes

Supplies and Drugs for Outpatient Services (supp drug op)

77,141 Bytes138,240 Bytes

TAR Completion (tar comp)

294,934 Bytes543,232 Bytes

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)

29,977 Bytes124,416 Bytes

TAR Field Office Addresses (tar field)

104,194 Bytes151,552 Bytes

TAR Submission: Transmittal Form (tar submis)

10,532 Bytes33,792 Bytes

TAR: Submitting Appeals (tar submit)

369,974 Bytes562,176 Bytes

UB-04 Completion: Outpatient Services (ub comp op)

25,187 Bytes62,976 Bytes

UB-04 Special Billing Instructions for Outpatient Services (ub spec op)

21,512 Bytes88,576 Bytes

UB-04 Submission and Timeliness Instructions (ub sub)

14,952 Bytes58,368 Bytes

UB-04 Tips for Billing: Outpatient Services (ub tips op)

33,921 Bytes141,312 Bytes

Vaccines For Children (VFC) Program (vaccine)



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