Part 2 - Inpatient Services (IPS)

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)
Administrative Days (admin) (Revision Date Jun 16, 2022) |180KB)
Ancillary Codes (ancil cod) (Revision Date Feb 17, 2021) |172KB)
Appeal Form Completion (appeal form) (Revision Date May 16, 2022) |632KB)
CCS Program Billing Guidelines (cal child bil guide) (Revision Date Jun 16, 2022) |77KB)
CIF Completion (cif co) (Revision Date May 16, 2022) |710KB)
CIF Submission and Timeliness Instructions (cif sub) (Revision Date Oct 16, 2020) |177KB)
Medi-Cal Dental Program (denti) (Revision Date May 14, 2021) |111KB)
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)
HCPCS Introduction (hcpcs) (Revision Date Aug 14, 2020) |114KB)
Hoptel Services (hoptel) (Revision Date Aug 14, 2020) |92KB)
Hospice Care (hospic) (Revision Date Aug 14, 2020) |167KB)
Hospital Directory (hospital dir) (Revision Date Aug 14, 2020) |106KB)
Hysterectomy (hyst) (Revision Date Dec 16, 2021) |196KB)
Inpatient Mental Health Services Program (inp ment) (Revision Date Aug 14, 2020) |447KB)
Inpatient Rehabilitation Services (inp rehab) (Revision Date Jun 16, 2022) |113KB)
Medicine (medne) (Revision Date Jun 16, 2022) |244KB)
Mental Disease Institutions Directory (mental) (Revision Date Aug 14, 2020) |102KB)
Minor Consent Program (minor) (Revision Date Aug 14, 2020) |134KB)
Newborn Hearing Screening Program (newborn) (Revision Date Aug 14, 2020) |117KB)
Obstetrics: Revenue Codes and Billing Policy (ob rev) (Revision Date Aug 31, 2020) |208KB)
Other Health Coverage (OHC) (oth hlth) (Revision Date Dec 31, 2021) |93KB)
Remittance Advice Details (RAD) (remit adv) (Revision Date May 16, 2022) |131KB)
Revenue Codes for Inpatient Services (rev cd ip) (Revision Date Aug 31, 2020) |132KB)
Form: Revenue Rate Change Request (DHCS 6004) (Revision Date May 29, 2020) |35KB)
Sign Language Interpretation (sign) (Revision Date Aug 31, 2020) |136KB)
Sterilization (ster) (Revision Date Aug 31, 2020) |1269KB)
TAR Completion (tar comp) (Revision Date Jun 16, 2022) |398KB)
Form: Call List for NF Placement (tar crit dp3 form) (Revision Date Sep 16, 2020) |113KB)
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)
Transplants (transplant) (Revision Date Oct 15, 2021) |214KB)
Transplants: Donor Protocol (transplant proto) (Revision Date Aug 31, 2020) |102KB)
UB-04 Completion: Inpatient Services (ub comp ip) (Revision Date Aug 16, 2021) |658KB)
UB-04 Submission and Timeliness Instructions (ub sub) (Revision Date Feb 16, 2022) |167KB)

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