HIPAA: Code Conversions
The Health Insurance Portability and Accountability Act (HIPAA) now mandates the standardization of internal (administrative) code sets and the use of standard service/procedure code sets for transactions. CenCal Health has been working diligently to convert its interim (local) codes to national values.
The code conversion establishes HIPAA-compliant procedure codes for services rendered by replacing the non-HIPAA-compliant codes. The alternative solution includes utilization of revenue codes, CPT codes, HCPCS Level II codes, and modifiers.
Effective for dates of service on and after July 1, 2017, CenCal Health will no longer accept non-HIPAA-compliant codes, with the exception of FQHC codes. The FQHC crosswalk will continue as scheduled in the State Medi-Cal website.