Erroneously Denied Claims for Vaccines Billed Using SK and SL Modifiers

January 15, 2021

The Department of Health Care Services (DHCS) has identified a claims processing issue that causes claims billed after July 1, 2020, for CPT® codes using SK and SL modifiers to be denied.

DHCS is aware of this issue and is working on a resolution to stop these claims from being denied. A workaround is in place that should stop denials and process all the affected claims until a permanent solution is implemented.

Providers can now submit claims for processing and appropriate reimbursement. There will be a notification regarding an Erroneous Payment Correction to reprocess all the denied claims in a future Medi-Cal Update.