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Part 2 - Durable Medical Equipment and Medical Supplies (DME)

Medi-Cal Program (00medi-cal) (Revision Date Apr 16, 2021) |95KB)

How to Use This Manual (0B hw to use) (Revision Date Feb 16, 2022) |392KB)

Getting Started: Where to Find the Answers (0C get start) (Revision Date Jan 14, 2022) |269KB)

Appeal Form Completion (appeal form) (Revision Date May 16, 2022) |632KB)

California Children’s Services (CCS) Program (cal child) (Revision Date Dec 31, 2021) |166KB)

California Children’s Services (CCS) Program Approved Hospitals (cal child appr) (Revision Date Aug 14, 2020) |111KB)

California Children’s Services (CCS) Program Billing (cal child bil) (Revision Date Jun 16, 2022) |140KB)

California Children’s Services (CCS) Program Billing Example: CMS-1500 (cal child bil cms) (Revision Date Jun 16, 2022) |602KB)

CCS Program Billing Guidelines (cal child bil guide) (Revision Date Jun 16, 2022) |77KB)

California Children’s Services (CCS) Program County Office Directory (cal child county) (Revision Date Oct 15, 2021) |182KB)

California Children’s Services (CCS) Program Eligibility (cal child elig) (Revision Date Jun 16, 2022) |170KB)

California Children’s Services (CCS) Program Medical Therapy Program (cal child med) (Revision Date Nov 30, 2021) |158KB)

California Children’s Services (CCS) Program Provider Paneling (cal child panel) (Revision Date Nov 30, 2021) |207KB)

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Physicians and Podiatrists (DHS 4514) (Revision Date May 29, 2020) |44KB)

Form: California Children’s Services (CCS) Program Individual Provider Paneling Application for Allied Health Care Professionals (DHS 4515 ) (Revision Date May 29, 2020) |69KB)

California Children’s Services (CCS) Program Referrals (cal child ref) (Revision Date Jun 16, 2022) |147KB)

California Children’s Services (CCS) Program Service Authorization Request (SAR) (cal child sar) (Revision Date Apr 29, 2022) |227KB)

California Children’s Services (CCS) Program Service Code Groupings (cal child ser) (Revision Date Jan 31, 2022) |498KB)

California Children’s Services (CCS) Program Special Care Centers (cal child spec) (Revision Date Sep 16, 2020) |91KB)

CIF Completion (cif co) (Revision Date May 16, 2022) |710KB)

CIF Special Billing Instructions (cif sp) (Revision Date Dec 31, 2021) |623KB)

CIF Submission and Timeliness Instructions (cif sub) (Revision Date Oct 16, 2020) |177KB)

CMS-1500 Completion (cms comp) (Revision Date May 16, 2022) |843KB)

CMS-1500 Special Billing Instructions (cms spec) (Revision Date Oct 16, 2020) |212KB)

CMS-1500 Submission and Timeliness Instructions (cms sub) (Revision Date Feb 16, 2022) |126KB)

CMS-1500 Tips for Billing (cms tips) (Revision Date Oct 16, 2020) |165KB)

Correct Coding Initiative: National (correct) (Revision Date Jun 16, 2022) |159KB)

Correct Coding Initiative: National – Claim Preparation (correct cod) (Revision Date May 16, 2022) |241KB)

Durable Medical Equipment (DME): An Overview (Revision Date Jun 16, 2022) |150KB)

Form: Certificate of Medical Necessity for All Durable Medical Equipment (DME) (Except Wheelchairs and Scooters) (DHS 6181) (Revision Date May 29, 2020) |127KB)

Form: Certificate of Medical Necessity for Apnea Monitors (MC 4600) (Revision Date May 29, 2020) |29KB)

Form: Certificate of Medical Necessity for Nebulizers (MC 4601) (Revision Date May 29, 2020) |27KB)

Form: Certificate of Medical Necessity for Oxygen (MC 4602) (Revision Date May 29, 2020) |63KB)

Durable Medical Equipment (DME): Bill for DME (dura bil) (Revision Date Oct 15, 2020) |212KB)

Durable Medical Equipment (DME): Bill for Wheelchairs and Wheelchair Accessories (dura bil wheel) (Revision Date Jul 16, 2021) |203KB)

Form: Certificate of Medical Necessity for a Manual Wheelchair, Standard or Custom (DHS 6181-A) (Revision Date May 29, 2020) |474KB)

Form: Certificate of Medical Necessity for a Motorized Wheelchair, Custom or Standard (DHS 6181-B) (Revision Date May 29, 2020) |447KB)

Form: Certificate of Medical Necessity for a Power Operated Vehicle (POV) aka Scooter, Standard or Bariatric (DHS 6181-C) (Revision Date May 29, 2020) |390KB)

Durable Medical Equipment (DME): Billing Codes and Reimbursement Rates (dura cd) (Revision Date Nov 16, 2021) |865KB)

Durable Medical Equipment (DME): Billing Codes for California Children’s Services (CCS) (dura cd ccs) (Revision Date Nov 30, 2021) |116KB)

Durable Medical Equipment (DME) Billing Codes: Frequency Limits (dura cd fre) (Revision Date Apr 15, 2022) |277KB)

Durable Medical Equipment (DME): Billing Examples (dura ex) (Revision Date Sep 16, 2020) |4011KB)

Durable Medical Equipment (DME): Infusion Equipment (dura inf) (Revision Date Nov 16, 2021) |136KB)

Durable Medical Equipment (DME): Other DME Equipment (dura other) (Revision Date Apr 15, 2022) |333KB)

Durable Medical Equipment (DME): Oxygen and Respiratory Equipment (dura oxy) (Revision Date Apr 15, 2022) |449KB)

Durable Medical Equipment (DME): Speech Generating Devices (SGD) (dura spe) (Revision Date Jul 16, 2021) |134KB)

Durable Medical Equipment (DME): Therapeutic Anti-Decubitus Mattresses and Bed Products (dura thp) (Revision Date Jul 16, 2021) |374KB)

Durable Medical Equipment (DME): Wheelchair and Wheelchair Accessories Guidelines (dura wheel guide) (Revision Date Jul 16, 2021) |273KB)

Enteral Nutrition Products (enteral) (Revision Date Apr 29, 2022) |89KB)

Forms: Legibility and Completion Standards (forms leg) (Revision Date Oct 16, 2020) |129KB)

Forms Reorder Request: Guidelines (forms reo) (Revision Date Dec 31, 2021) |107KB)

Forms Reorder Request: Medical Services and Allied Health (forms reo ma) (Revision Date Sep 16, 2020) |375KB)

Genetically Handicapped Persons Program (GHPP) (genetic) (Revision Date Dec 31, 2021) |246KB)

HCPCS Introduction (hcpcs) (Revision Date Aug 14, 2020) |114KB)

HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes (hcpcs iii) (Revision Date Aug 31, 2020) |143KB)

Incontinence Medical Supplies (incont) (Revision Date Apr 29, 2022) |229KB)

Incontinence Medical Supplies Example: CMS-1500 (incont ex) (Revision Date Apr 29, 2022) |501KB)

Intravenous or Intra-arterial Solutions: Administration Sets (iv sol admin) (Revision Date Aug 31, 2020) |108KB)

Medical Supplies (mc sup) (Revision Date Apr 29, 2022) |245KB)

Medical Supplies: Billing Examples (mc sup ex) (Revision Date Jul 30, 2021) |719KB)

Medicare/Medi-Cal Crossover Claims: CMS-1500 (medi cr cms) (Revision Date Apr 15, 2022) |267KB)

Medicare/Medi-Cal Crossover Claims: CMS-1500 Billing Examples for Allied Health (medi cr cms exa) (Revision Date Aug 31, 2020) |360KB)

Medicare/Medi-Cal Crossover Claims: CMS-1500 Pricing Examples for Allied Health (medi cr cms pra) (Revision Date Aug 31, 2020) |591KB)

Medicare/Medi-Cal Crossover Claims: UB-04 (medi cr ub) (Revision Date Sep 16, 2020) |186KB)

Medicare/Medi-Cal Crossover Claims: UB-04 Billing Examples (medi cr ub ex) (Revision Date Aug 31, 2020) |1330KB)

Medicare Non-Covered Services: Charts Introduction (medi non cha) (Revision Date May 14, 2021) |107KB)

Medicare Non-Covered Services: HCPCS Codes (medi non hcp) (Revision Date Jun 16, 2022) |129KB)

Modifiers: Approved List (modif app) (Revision Date Jun 16, 2022) |339KB)

Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Orthotics (ortho cd1) (Revision Date Aug 14, 2020) |486KB)

Orthotic and Prosthetic Appliances: Billing Codes and Reimbursement Rates – Prosthetics (ortho cd2) (Revision Date Feb 16, 2022) |367KB)

Orthotics and Prosthetics: Frequency Limits for Orthotics (ortho cd fre1) (Revision Date Aug 31, 2020) |265KB)

Orthotics and Prosthetics: Frequency Limits for Prosthetics (ortho cd fre2) (Revision Date May 16, 2022) |243KB)

Other Health Coverage (OHC) (oth hlth) (Revision Date Dec 31, 2021) |93KB)

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil) (Revision Date Dec 31, 2021) |127KB)

Remittance Advice Details (RAD) (remit adv) (Revision Date May 16, 2022) |131KB)

Remittance Advice Details (RAD) Examples: Allied Health, Medical Services and Pharmacy (remit ex amp) (Revision Date Jan 14, 2022) |294KB)

Remittance Advice Details (RAD): Payments and Claim Status (remit pay) (Revision Date May 16, 2022) |75KB)

Respiratory Care (respir) (Revision Date Dec 16, 2021) |190KB)

Share of Cost (SOC): CMS-1500 (share cms) (Revision Date Dec 31, 2021) |823KB)

Sign Language Interpretation (sign) (Revision Date Aug 31, 2020) |136KB)

TAR Completion (tar comp) (Revision Date Jun 16, 2022) |398KB)

TAR Criteria for NF Authorization (Valdivia v. Coye) (tar crit nf) (Revision Date Dec 16, 2021) |187KB)

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer) (Revision Date Dec 31, 2021) |1563KB)

TAR Field Office Addresses (tar field) (Revision Date Dec 31, 2021) |357KB)

TAR Submission: Transmittal Form (tar submis) (Revision Date Aug 31, 2020) |220KB)

TAR: Submitting Appeals (tar submit) (Revision Date Sep 28, 2020) |114KB)

Taxable and Non-Taxable Items (tax) (Revision Date Apr 15, 2022) |692KB)

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