Claims Corner

Recent Billing/Policy Update Articles

Attention	Articles	Posting Date
Physicians, Outpatient Hospitals, and Clinics	Proposition 56 Supplemental Payments	April 2018
Physicians, Outpatient Hospitals, Clinics, and Laboratories	New Benefit: Additional Gene Tests Billable under Molecular Pathology CPT-4 codes (81406,81404 and 81405)	March 2018
Physicians, Outpatient Hospitals, Clinics, and Laboratories	New Benefit: Surgical Pathology (88365)	March 2018
Physicians, Outpatient Hospitals, and Clinics	Policy Update: Nerve Pedicle Transfer (64905)	March 2018
Physicians, Outpatient Hospitals, and Clinics, Transportation	Policy Update: Medical Transportation Dry Runs (A0225)	March 2018
Physicians, Outpatient Hospitals, and Clinics, Home Health Agencies	Policy Update: Face to Face Encounters for Home Health Services	March 2018
Physicians, DME, Orthotics & Prosthetics, and Physical Therapy	Rate Update: Knee Orthosis Codes L1851 and L1852	March 2018
ALL PROVIDERS	2017 and 2018 CPT-4/HCPCS Update	February 2018
Physicians, Outpatient Hospitals, Clinics, and Laboratories	Policy Update: Microsatellite Instability Analysis	February 2018
Physicians, DME, Orthotics & Prosthetics, and Physical Therapy	Policy Update: Wheelchair and Scooter Repair and Maintenance	February 2018
ALL PROVIDERS	Annual 2018 CPT-4/HCPCS Code Update	January 2018
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Pulmonary Rehabilitation (G0424)	January 2018
Physicians, Outpatient Hospitals, and Clinics	Upcoming Benefit: Diabetes Prevention Program	January 2018
Physicians, Outpatient Hospitals, and Clinics	Policy Update: Mammography Codes 77065 and 77066	January 2018
Physicians, Outpatient Hospitals, Clinics, and Laboratories	Policy Update: Neuropsychological Testing	January 2018
Physicians, Outpatient Hospitals, and Clinics	Billing Update: Place of Service Code Update on Sleep Study and Polysomnography Codes	January 2018
Physicians, Outpatient Hospitals, Clinics, Vision Providers, and Ophthalmologists	Billing Update: Ophthalmic Biometry (92136)	January 2018
Physicians, Outpatient Hospitals, Clinics, and Laboratories	Billing Update: KIT Gene Analysis (81272)	January 2018
ALL PROVIDERS	STILL USING PAPER TO SUBMIT CLAIMS?	January 2017

February 2018

March 2018

Upcoming New Benefits

The following notifications have been identified as upcoming "New Benefits" CenCal Health recently became aware of and plans to adopt. These notices are informative only and will not be implemented until an effective date of service has been established; therefore, provider billing changes are not required at this time.

To ensure proper billing and avoid unnecessary denials, please be sure to check the "Recent Billing/Policy Updates" section monthly for articles posting the effective date and specific billing/policy details related to the "New Benefits" notifications below.

Attention	Notifications	Posting Date
ALL PROVIDERS	CenCal Health is not currently aware of any upcoming New Benefits at this time. Please check back for future updates.	March 2018

Upcoming Policy and Rate Changes

The following notifications have been identified as upcoming "Policy and/or Rate Changes" CenCal Health recently became aware of and plans to adopt. These notices are informative only and will not be implemented until an effective date of service has been established; therefore, provider billing changes are not required at this time.

Attention	Notifications	Posting Date
Physicians, Outpatient Hospitals and Clinics	Policy Update for Nerve Pedicle Transfer, First Stage (CPT-4 Code 64905)	February 2018
Family Planning Providers	Policy Update for Clinic Dispensing of Contraceptive Vaginal Ring (HCPCS Code J7303), Transdermal Patch (HCPCS Code J7304) and Oral Contraceptives (HCPCS Code S4993)	February 2018
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for CPT-4 Codes 81245 (FLT3 GLT3 GE) and 81246 (FLT3 GENE ANALYSIS)	February 2018
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Lynch Syndrome Genetic Testing	November 2017
Physicians, Outpatient Hospitals and Clinics	Policy Update for Polysomnography (CPT-4 Codes 95807, 95808, 95810, 95811, 95782 and 95783)	December 2016

Upcoming Diagnosis Restriction Changes

The following notifications have been identified as upcoming changes related to "Diagnosis Restrictions" CenCal Health recently became aware of and plans to adopt. These notices are informative only and will not be implemented until an effective date of service has been established; therefore, provider billing changes are not required at this time.

Attention	Notifications	Posting Date
ALL PROVIDERS	CenCal Health is not currently aware of any upcoming Diagnosis Updates at this time. Please check back for future updates.	March 2018

Upcoming Code Conversions

The following notifications have been identified as upcoming HIPAA-compliant "Code Conversions" CenCal Health recently became aware of and plans to adopt. These notices are informative only and will not be implemented until an effective date of service has been established; therefore, provider billing changes are not required at this time.

Attention	Notifications	Posting Date
LTC Providers	COMING SOON -- Effective for dates of service TBD -- LTC local codes (01-98) will be terminated. Providers should bill using the appropriate HIPAA-compliant Revenue Codes. Please refer to the HIPAA section of our website for the latest conversion details.	July 2017
Outpatient Hospitals	COMING SOON -- Effective for dates of service TBD -- local codes for Hospital Outpatient Services (Z7500-Z7514, Z7610-Z7614) will be terminated. Providers should bill using the appropriate HIPAA compliant, nationally recognized revenue codes, CPT-4 codes and/or HCPCS codes that best represents the service provided. Please refer to the HIPAA section of our website for the latest conversion information.	July 2017
FQHC, RHC and IHS-MOA Providers	Effective for DOS on or after October 1, 2017 -- FQHC/RHC Local Codes (001-021) will be converted to specific HIPAA-compliant CPT-4/HCPCS/Revenue Code combinations. See the July 2017 article under the "Recent Billing/Policy Updates" tab for additional details on this conversion.	July 2017
ALL PROVIDERS	Effective for dates of service on or after July 1, 2017 -- CenCal Health will terminate ALL the local codes (X-codes & Z-codes). Providers should bill using the appropriate national HCPCS code and/or CPT-4 code, including the appropriate Revenue Code where applicable, that best represents the service provided. Please refer to the HIPAA section of our website for the latest conversion details.	June 2017

ARCHIVE - 2017 Recent Billing/Policy Update Articles

Here you will find previously posted 2017 articles from the "Recent Billing/Policy Updates" section

Attention	ARCHIVED 2017 Recent Billing/Policy Update Articles	Original Posting Date
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Cuvitru for Primary Humoral Immunodeficiency (billable under HCPCS code J3590)	December 2017
Physicians, Outpatient Hospitals, and Clinics	Billing Update: Modifier ZA (when billing Zorxio with HCPCS Code Q5101)	December 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update: Bevacizumab 10 mg Injection (HCPCS Code J9035)	December 2017
DME, Orthotics & Prosthetics, and Physical Therapy	Policy Update: HCPCS code L3000 (Orthotic Foot Insert)	December 2017
Physicians, DME, Orthotics & Prosthetics, and Physical Therapy	Policy Update: Lower Extremity, Thoracic Control (HCPCS Codes L2670 and L2680)	December 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update: Cystourethroscopy Services (CPT-4 Codes 52441 and 52442)	December 2017
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Nusinersen 0.1mg injection (C9489), Bezlotoxumab 10mg injection (C9490) and Ustekinumab, for intravenous injection, 1mg (Q9989)	November 2017
Physicians, Outpatient Hospitals, and Clinics	Billing Update: Modifier ZB (when billing Inflectra with HCPCS Code Q5102)	November 2017
Physicians, Outpatient Hospitals, and Clinics	Billing Update: Modifier ZC (when billing Renflexis with HCPCS Code Q5102)	November 2017
Physicians, Outpatient Hospitals, Clinics, and Laboratories	Policy Update for Breast Cancer Gene Analysis (CPT-4 Codes 81211, 81213 and 81162)	November 2017
Physicians, Outpatient Hospitals, Clinics, and Laboratories	Policy Update for Hereditary Colon Cancer Disorder (CPT-4 Codes 81435 and 81436)	November 2017
Physicians, Outpatient Hospitals, and Clinics, DME	Policy Update: DME Wheelchair and Wheelchair Accessory Guidelines	November 2017
Physicians, Outpatient Hospitals, and Clinics, DME and Obstetricians	Policy Clarification: Rental/Purchase of Breast Pumps	November 2017
Physicians, Outpatient Hospitals, Clinics, Vision Providers, and Ophthalmologists	Diagnosis Update for Professional Vision and Ophthalmology Services	November 2017
Physicians, Outpatient Hospitals, Clinics and Obstetricians	Annual 2017 CPT4/HCPCS Code Update Revisions	October 2017
Physicians, Outpatient Hospitals, and Clinics	Immunization and Vaccines FAQs	October 2017
Physicians, Outpatient Hospitals, Clinics and Obstetricians	New Benefit: Pathogen(s) Test for Platelets HCPCS Code Q9987	October 2017
Physicians, Outpatient Hospitals, and Clinics	Rate Update for Skin Lesion Surgery CPT-4 Codes 17110 and 17111	October 2017
Physicians, Outpatient Hospitals, Clinics, Obstetricians and Laboratories	Policy Update for HIV Screening and Infectious Agent Detection HCPCS Code G0475 and CPT-4 Code 87801	October 2017
ALL PROVIDERS	Annual Update 2017 CPT-4/HCPCS Codes- Additional Information	September 2017
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Siltuximab 10 mg Injection	September 2017
Physicians, Outpatient Hospitals, Clinics and Obstetricians	New Benefit: Surgical and Preventative Preterm Birth HCPCS Codes (C9745-C9747 and Q9985-Q9986)	September 2017
Physicians, Outpatient Hospitals, Clinics, Obstetricians and Gynecologists	Policy Update for Sterilization CPT-4 Codes 58661 (Laparoscopy) and 58700 (Salpingectomy)	September 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Allergen Specific IgE Testing (CPT-4 Code 86003)	September 2017
DME, Orthotics & Prosthetics, and Physical Therapy	Policy Update for Several DME HCPCS Codes	September 2017
Physicians, Outpatient Hospitals, and Clinics	Billing Update: Cardiac Magnetic Imaging Resonance for Morphology (CPT-4 Code 75561)	September 2017
Audiology, DME, Orthotics & Prosthetics, and Physical & Occupational Therapy	Billing Update to Specific Orthotics & Prosthetics HCPCS Codes	September 2017
Physicians, Outpatient Hospitals, Clinics and FQHCs/RHCs/IHS-MOAs	Billing Update: End of Life Option Services	September 2017
FQHCs/RHCs/IHS-MOAs	Billing Update for Service Authorization Requests (SARs)	September 2017
Clinical Laboratories	Rate Update for Clinical Laboratory Services	September 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	Billing Update: Drug Testing HCPCS Codes G0477-G0479 to be Discontinued	August 2017
ALL PROVIDERS	Annual Update for 2017 CPT-4/HCPCS Codes	August 2017
Physicians, Outpatient Hospitals, Clinics and Ophthalmologists	Policy Update for Eye and Ocular Adnexa Surgery (CPT-4 Codes 65778, 65779, 66820, 66821)	August 2017
DME Providers	Policy Update for Sterile Needles (HCPCS Code A4125)	August 2017
FQHC, RHC and IHS-MOA Providers	Additional Information for HIPAA Conversion Update	August 2017
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Cardiac Magnetic Resonance Imaging (CPT-4 Code 75561)	July 2017
Physicians, Outpatient Hospitals, and Clinics	New Benefits under Physicians Administered Drugs (HCPCS Codes C9484-C9488)	July 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Modifier KX	July 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Lanreotide 1 mg Injection (HCPCS Code J1930)	July 2017
Physicians, Outpatient Hospitals, and Clinics	Rate Update for Pulmonary Valve Implantation (CPT-4 Code 33477)	July 2017
FQHC, RHC and IHS-MOA Providers	Billing Update: HIPAA Code Conversion Coming Soon	July 2017
Physicians, Outpatient Hospitals, Clinics and Family Planning Providers	New Benefit: Contraceptive Cervical Cap and Diaphragm (HCPCS Codes A4261 and A4266)	June 2017
Physicians, Outpatient Hospitals, Clinics and Family Planning Providers	New Benefit: Levonorgestrel-releasing Intrauterine System, 19.5 mg (HCPCS Code S4989)	June 2017
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Procalcitonin Assay (CPT-4 code 84145)	June 2017
ALL PROVIDERS	New Benefit: Modifier 95	June 2017
Indian Health Services Providers	Policy update for Acupuncture Services	June 2017
Inpatient Hospitals	Policy Update for Emergency Room Reimbursement Policy	June 2017
Physicians, Outpatient Hospitals, Clinics and DME Providers	Policy Update for DME Prescriptions	June 2017
Physicians, Outpatient Hospitals, Clinics and DME Providers	Policy Update for Medical/Incontinence Supplies and Enteral Nutrition Prescriptions	June 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for ECMO/ECLS Services	June 2017
Physicians, Outpatient Hospitals, Clinics and Obstetricians	Policy Update for Pregnancy Services	June 2017
Physicians, Outpatient Hospitals, Clinics and Obstetricians	Policy Update for Select Ultrasound Services (CPT-4 Codes 76514, 76830, 76856 and 76857)	June 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Zoster Vaccine (CPT-4 codes 90736)	June 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Allergen Immunotherapy Injections (CPT-4 Codes 95115 and 95117)	June 2017
DME Providers	Policy Update for Blood Pressure Monitor (HCPCS Code A4670)	June 2017
DME Providers	Policy Update for DME Oxygen and Respiratory Equipment	June 2017
Physicians, Outpatient Hospitals, and Clinics	Rate Update for Ureter and Urethra Surgery Services (CPT-4 Codes 52441, 52442, 53850 and 53852	June 2017
Physicians, Outpatient Hospitals, and Clinics	Rate Update for Application of Topical Fluoride Varnish (CPT-4 Code 99188)	June 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	New Benefit: SMN1/SMN2 Gene Test (CPT-4 Code 81401)	May 2017
Physicians, Outpatient Hospitals and Clinics	Diagnosis Restrictions Update for Bevacizumab 10 Mg Injection (HCPCS code J9035)	May 2017
DME Providers	Policy Update for Medical Supply Invoices	May 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	Medi-Cal Rate Update for CPT-4 codes 88112 (Cytopathology, Selective Cellular Enhancement Technique) and 88333 (Pathology Consultation during Surgery)	May 2017
Physicians, Outpatient Hospitals and Clinics	Medi-Cal Rate Update for CPT-4 code 11042 (debridement, subcutaneous tissue)	May 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Clarification for SMN1 Gene Tests (CPT-4 Codes 81400, 81403 & 81405)	May 2017
Physicians, Outpatient Hospitals and Clinics	UPDATE: HIPAA Conversion of Intravenous Solutions (Local Codes X7700 & X7702)	April 2017
Physicians, Outpatient Hospitals and Clinics	New Benefit: Carbidopa and Levodopa Enteral Suspension (HCPCS Code J7340)	April 2017
Physicians, Outpatient Hospitals, Clinics, Family Planning Providers	Policy Update for Clinic Dispensing of Contraceptive Supplies (HCPCS Codes J7303 and J7304)	April 2017
DME Providers	Policy Update for Obstructive Sleep Apnea (OSA)	April 2017
Medical Transportation Providers	Policy Update for Medical Transportation related to Emergency Statements, Round Trips, Night Calls and Non-Emergency Transports	April 2017
Physicians, Outpatient Hospitals, Clinics and Radiologists	New Benefit: Abdominal Ultrasound Services (HCPCS Code C9744)	March 2017
Physicians, Hospitals and Clinics	Policy Update for ECMO and ECLS Services	March 2017
Physicians, Outpatient Hospitals, and Clinics	HIPAA Conversion for Inhalation Solutions (Local Codes X7700 and X7702)	March 2017
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Central Nervous System Assessments/Tests	February 2017
DME Providers	Pricing Policy Update for Wheelchair Accessory	February 2017
DME and Prosthetics & Orthotics Providers	Policy Update for HCPCS L1902 (Prefabricated Ankle Orthosis)	February 2017
ALL PROVIDERS	Policy Update for Revenue Codes	January 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	New Benefit: EndoPredict (CPT-4 Code 81599)	January 2017
Physicians, Outpatient Hospitals, and Clinics	New Flu Vaccine: Flucelvax (CPT-4 Code 90674)	January 2017
Physicians, Outpatient Hospitals, and Clinics	New Injection Codes: Atezolizumab (HCPCS Code C9483), Reslizumab (HCPCS Code C9481) and Sotalol (HCPCS Code C9482)	January 2017
Physicians, Outpatient Hospitals, Clinics and Allergy Providers	Policy Update for Allergy Desensitization Services (CPT-4 Codes 95115 and 95117)	January 2017
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Colorectal Cancer Screening (CPT-4 codes 81528)	January 2017
Podiatrists	Policy Clarification for Podiatry Services	January 2017

ARCHIVE - 2016 Recent Billing/Policy Update Articles

Here you will find previously posted 2016 articles from the "Recent Billing/Policy Updates" section

Attention	ARCHIVED 2016 Recent Billing/Policy Update Articles	Original Posting Date
Physicians, Outpatient Hospitals, Clinics and Radiologists	New Benefit: Pet Scan Diagnostic Agents Flutemetamol (HCPCS Code Q9982) and Florbetaben (HCPCS Code Q9983)	December 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Helicobacter Pylori (CPT-4 Code 87338)	December 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Various Physician-Administered Drugs	November 2016
Physicians, Outpatient Hospitals and Clinics	2017 ICD-10 Update for Family Planning Services	November 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Darbepoetin Alfa (HCPCS Code J0882)	November 2016
Hospitals, Physicians and Clinics	Policy Update for Gender Dysphoria Treatment	November 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Noninvasive Prenatal Testing Coverage (CPT-4 Codes 81420, 81479 & 81507)	November 2016
Obstetricians, Physicians, Outpatient Hospitals and Clinics	Policy Update for Certified Nurse Midwives (CNM) - Cesarean Delivery "Assistant at Surgery"	November 2016
DME Providers	Correction to Policy for DME Separately Reimbursable Items for LTC Recipients	November 2016
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Fetal Congenital Abnormalities (CPT-4 Codes 81508-81512)	November 2016
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Nerve Conduction Studies (CPT-4 Codes 95905, 95907-95912)	November 2016
Physicians, Outpatient Hospitals and Clinics	Rate Update for Medical Nutrition Therapy (CPT-4 Code 97804)	November 2016
Hospitals, Physicians, Clinics and Radiologists	New Benefit: Functional MRI Brain Mapping (CPT-4 Codes 70554, 70555 & 96020)	October 2016
Cardiologists, Physicians, Outpatient Hospitals and Clinics	Policy Update for Cardiology Service Codes (CPT-4 Codes 92920-92979, 92992-92998, 93451-93533 and 93561-93657) Billable with Modifier 53 (discontinued procedure)	October 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Laboratory Codes (CPT-4 Codes 80000-89999) Billable with Modifier 33 (preventive service)	October 2016
Dialysis Providers	Policy Update for Some Chronic Dialysis Local Codes (Z6000-Z6052)	October 2016
DME Providers	Policy Update for Fixed Height Hospital Beds	October 2016
DME Providers	Policy Update for Cough Stimulating Device Supplies (HCPCS Codes A7020, A7027-A7045 & E0482)	October 2016
ALL PROVIDERS	2016 CPT-4/HCPCS Annual Update	September 2016
Physicians and PCPs	New End of Life Option Act (ELOA) Services	September 2016
ALL PROVIDERS	2017 ICD-10 Diagnosis Codes Update	September 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	New Benefit: Arsenic Trioxide 1 mg Injection (HCPCS Code J9017)	September 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	New Benefit: Tecentriq billable under HCPCS Code J3490 (unclassified drugs)	September 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Colorectal Cancer Screening (HCPCS Code G0464)	September 2016
Physicians, Outpatient Hospitals, Clinics and Radiologists	New Benefit: Coronary Computed Tomography Angiography (CCTA) and Coronary Magentic Resonance Imaging (CMRI) (CPT-4 Codes 75565, 75571-75574)	September 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Reslizumab billable under HCPCS Code J3590 (unclassified biologics)	September 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Mepolizumab billable under HCPCS Code J3590 (unclassified biologics)	September 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Oncoprotein Quantitative Test (CPT-4 Code 83951)	September 2016
Physicians, Outpatient Hospitals and Clinics	Policy Clarification for Spinal Neurostimulators (CPT-4 Codes 95970-95972)	September 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Molecular Pathology Level 8 (CPT-4 Code 81407)	September 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Diagnosis Update for Cardiac Implantable Devices and Stents	September 2016
Acupuncturists	Acupuncture Benefits Restored	August 2016
Speech Therapists	TAR Requirement Update for Speech Therapy Services	August 2016
DME Providers	Clarification for DME Rental Reimbursement Cap	August 2016
DME Providers	Clarification for Medical Supply Claims Invoice Requirements	August 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Intranasal Influenza Virus Vaccine	August 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Medical Abortion Drugs	August 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Smoking and Tobacco Cessation Counseling (CPT-4 codes 99406 and 99407)	July 2016
Physicians, Outpatient Hospitals and Clinics	Clarification: Home Health Per Visit Allowance	July 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for Pregnancy-Related Services (CPT-4 codes 59025,76801,76816, & 76825-76828)	July 2016
Psychological Services	Billing Update for CMS-1500 claim form	July 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for Abduction Bar Orthotic Code (HCPCS code L2300)	July 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Influenza Treatment Drug Peramivir (HCPCS code J2547)	June 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Percutaneous Coronary Intervention (HCPCS code C9460)	June 2016
DME Providers	New Benefit: Hypertension (HCPCS code A4670)	June 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Allergen Immunotherapy Services (CPT-4 codes 95144 and 95170)	June 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Filgrastim-sndz (HCPCS code Q5101)	June 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Molecular Pathology (CPT-4 codes 81161 and 81408)	June 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	Policy Update for Lynch Syndrome Genetic Testing (CPT-4 codes 81294, 81297, 81300, 81319, & 81403)	June 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Meningococcal Serogroup B Vaccine (CPT-4 codes 90620-90621)	June 2016
Physicians, Outpatient Hospitals, Clinics and Obstetricians	Policy Update for Pregnancy-Related Services (Local code Z1038)	June 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for CRNAs Billing Codes (CPT-4 codes 62267-62273,62280-62287,62290-62297,62310,62311,62318,62319,64400-64439, & 64444-64530)	June 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for Anesthesia Services (CPT-4 code 62318)	June 2016
Physicians, Outpatient Hospitals, and Clinics	Billing Update for Naloxone Hydrochloride (HCPCS code J2310)	June 2016
Physicians, Outpatient Hospitals and Clinics	Rate Update for Electrocardiogram Procedures (CPT-4 Codes 93000,93005, & 93010)	May 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	Policy Update for Gene Expression Profiling for Breast Cancer (CPT-4 Codes 81519 & 81599)	May 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Bariatric Surgery	May 2016
Physicians, Inpatient Hospitals, Outpatient Hospitals and Clinics	Policy Update for Liver-Lung and Liver-Heart Transplant	May 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Static Short Arm Splints (CPT-4 code 29125)	May 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Sterilization Procedures (CPT-4 Codes 58661,58700 & 58720)	May 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Hormone Injection Therapy	May 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Carfilzomib 1mg Injection (HCPCS Code J9047)	May 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for Nivolumab 1mg Injection (HCPCS Code J9299)	May 2016
Physicians, Outpatient Hospitals and Clinics	Billing Update for Pathology for HCPCS and CPT-4 Codes	May 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: DSMT HCPCS G0108-G0109 and MNT CPT-4 codes 97802-97804	May 2016
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Radiopharmaceutical Diagnostic Imaging billable under HCPCS code C9461	May 2016
Physicians, Outpatient Hospitals, and Clinics	New Benefit: Genectic testing for maturity onset diabetes (CPT-4 codes 81404-81406)	May 2016
Hospice Providers	Billing Update: HIPPA Compliant Code Conversion Updates	May 2016
Hospice Providers	Billing Update: HIPPA Compliant Code Conversion Updates	April 2016
Home Health Providers	Billing Update: HIPPA Compliant Code Conversion Updates	April 2016
Medical Transportation Providers	Billing Update: HIPPA Compliant Code Conversion Updates	April 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Dispensing Fee	April 2016
ALL PROVIDERS	CMS 1500 Claim Form Update for Rendering Provider Id Number	April 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	New Benefit: Necitumumab Billable Under HCPCS Code J3590 (Unclassified Biologics)	March 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	Policy Update for Pembrolizumab 1 mg Injection (HCPCS Code C9027)	March 2016
Physicians, Outpatient Hospitals, Clinics and Oncologists	Policy Update for Ipilimumab 1 mg Injection (HCPCS Code J9228)	March 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Doxorubicin Hydrochloride Liposome (HCPCS code J9002)	March 2016
Physicians, Outpatient Hospitals, Clinics and Obstetricians	Policy Update for BRCA 1, BRCA 2 Gene Analysis (CPT-4 Codes 81211 & 81213)	March 2016
Podiatrists	Policy Update for MRI Codes (CPT-4 Codes 73718-73723)	March 2016
Physicians, Outpatient Hospitals and Clinics	Rate Update for Epix and Theraskin Codes (HCPCS Codes Q4121 and Q4131)	March 2016
Physicians, Outpatient Hospitals and Clinics	Rate Update for Modifier UA and UB (modifiers for surgical and anesthesia-related supplies and drugs)	March 2016
ALL PROVIDERS	Billing for Dual Eligible Members	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Polysomnography Codes (CPT-4 Codes 95782, 95783, 95810 & 95811)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Reminder for Intraoperative Neurophysiology Monitoring (CPT-4 Codes 95940 & 95941)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Extracorporeal Membrane Oxygenation (ECMO) and Extra Corporeal Life Support (ECLS)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Filgrastim [G-CSF], Biosimilar, 1 mcg Injection (HCPCS Code Q5101)	February 2016
Physicians, Outpatient Hospitals and Clinics	Rate Update for Advance Care Planning Consultations (CPT-4 Codes 99497 & 99498)	February 2016
DME, Orthotics & Prosthetics Providers	Policy Update for Protective Helmet Codes (HCPCS Codes A8000-A8004)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Biochemical Assays (CPT-4 Codes 81500 & 81503)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Aflibercept 1 mg Injection (HCPCS Code J0178)	February 2016
Physicians, Outpatient Hospitals and Clinics	Policy Update for Nivolumab 1 mg Injections (HCPCS Code C9453)	February 2016
Obstetricians, Physicians, Outpatient Hospitals and Clinics	Policy Update for Antepartum Fetal Testing (CPT-4 Code 59025)	February 2016
Chiropractors	Diagnosis Code Update for Chiropractic Services (CPT-4 Codes 98940-98942)	February 2016
ALL PROVIDERS	Billing Update: External Cause of Morbidity Diagnosis Codes	January 2016
Obstetricians	Policy Update for Antepartum Visits and Global Obstetrical Billing	January 2016
Physicians, Outpatient Hospitals and Clinics	New Benefit: Sulfur Hexafluoride Lipid Microsphere, per ml (HCPCS code C9457)	January 2016
Physicians, Outpatient Hospitals, Clinics, Obstetricians, Gynecologists and Laboratories	Policy Update for Human Papillomavirus (HPV) Testing (CPT-4 Codes 87624 & 87625)	January 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for BRAF Gene Analysis (CPT-4 Code 81210)	January 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Molecular Pathology Procedure, Level 6 (CPT-4 81405)	January 2016
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Cytopathology, Cervical or Vaginal Slides (CPT-4 88164-88167)	January 2016
DME Providers	Policy Update for Bi-PAP and CPAP Equipment	January 2016
DME Providers	Policy Update for Electrical Stimulation Device (HCPCS Code E0766)	January 2016

ARCHIVE - 2015 Recent Billing/Policy Update Articles

Here you will find previously posted 2015 articles from the "Recent Billing/Policy Updates" section

Attention	ARCHIVED 2015 Recent Billing/Policy Update Articles	Original Posting Date
Physicians, Outpatient Hospitals and Clinics	Policy Update for Brentuximab Vedotin 1 mg Injection (HCPCS Code J9042)	December 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Meningitis Vaccines (CPT-4 Code 90734)	December 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Albumin Infusions (HCPCS Codes P9041, P9045, P9046 and P9047)	December 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Streptococcus Amplified Probe Technique (CPT-4 Code 87651)	December 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Total Disc Arthroplasty (CPT-4 Codes 22856 and 22858)	December 2015
Psychologists	Place of Service Clarification for Psychology Services	December 2015
Physicians, Outpatient Hospitals and Clinics	ICD-10 Diagnosis Code Updates for Hyperbaric Oxygen Therapy	December 2015
Hospice Providers, Physicians, Outpatient Hospitals and Clinics	Clarification of Hospice Face-to-Face Recertification	December 2015
ALL PROVIDERS	Policy Update for Medi-Cal Crossover Codes	December 2015
Oncologists, Physicians, Outpatient Hospitals and Clinics	New Benefit: Blinatumomab 1 mcg Injection (HCPCS Code C9449)	November 2015
Ophthamologists, Physicians, Outpatient Hospitals and Clinics	New Benefit: Fluocinolone Acentonide Intravitreal Implant (HCPCS Code C9450)	November 2015
Physicians, Obstetricians, Outpatient Hospitals and Clinics	New Benefit: Nivolumab 1 mg Injection (HCPCS Code C9453)	November 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Ziv-Aflibercept 1 mg Injection (HCPCS Code J9400)	November 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Intensive Behaviorial Therapy for Obesity (HCPCS Code G0473 and G0447)	November 2015
Family Planning Providers, Physicians, Outpatient Hospitals and Clinics	New Benefit: Onsite Dispensing of Contraceptive Vaginal Ring (HCPCS Code J7303) and Transdermal Patch (HCPCS Code J7304)	November 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Transprostatic Implants (CPT-4 Code 52442)	November 2015
Physicians, Outpatient Hospitals and Clinics	Clarification of Modifier QW for CLIA-Waived Codes	November 2015
DME Providers	Policy Clarification for Wheelchair Accessories (HCPCS Codes E1010 and K0108)	November 2015
ALL PROVIDERS	ICD-10 Update: New Explain Codes	October 2015
Family Planning Providers	Policy Update for Liletta, HCPCS Codes J7302 (Levonorgestrel-Releasing Intrauterine Contraceptive System), 52 mg	October 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Cystourethroscopy (HCPCS Codes C9739 and C9740)	October 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Alemtuzumab 1 mg Injection (HCPCS Code Q9979)	October 2015
DME, Orthotics and Prosthetics Providers	Policy Update for HCPCS Code A7048 (Vacuum Drainage Collection Unit and Tubing Kit, Each)	October 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Genetic Testing of Gliomas (CPT-4 Codes 81402, 81403 and 81479)	October 2015
DME, Orthotics and Prosthetics Providers	Policy Update for HCPCS Code E0445 (Oximeter Device for Measuring Blood Oxygen Levels Non-Invasively)	October 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Carfilzomib 1 mg Injection (HCPCS Code J9047)	October 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Molecular Pathology Codes 81250, 81287, 81404 and 81405	October 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Corticorelin Ovine Triflutate 1 mcg Injection (HCPCS Code J0795)	October 2015
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Zoledronic Acid 1 mg Injection (HCPCS Code J3489)	October 2015
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Injection Codes C9254, J0740 and J0775	October 2015
Physicians, Outpatient Hospital and Clinics	Diagnosis Update for Goserelin Acetate 3.6 mg Implant (HCPCS code J9202)	October 2015
Oncologists	Diagnosis Update for Chemotherapy Codes J1300, J9178, J9185 and J9390	October 2015
ALL PROVIDERS	ICD-10 Update: DHCS' Provider Manual Replacement Pages Posted	September 2015
ALL PROVIDERS	2015 CPT-4/HCPCS Annual Update: DHCS' Provider Manual Replacement Pages Posted	September 2015
DME Providers	DME Wheelchair Coverage Criteria Update	September 2015
DME Providers	New Benefit: Manual Wheelchair Accessory	September 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for HCPCS Code G6040 (Alcohol [Ethanol]; Any Specimen Except Breath	September 2015
Physicians, Outpatient Hospital and Clinics	Policy Update for Denosumab 1 mg Injection (HCPCS Code J0897)	September 2015
Physicians, Outpatient Hospital and Clinics	Rate Update for Speech Evaluation Codes (CPT-4 Codes 92521-92524)	September 2015
Physicians, Outpatient Hospital and Clinics	Diagnosis Update for CPT-4 Code 87389 (HIV-1 Antigen)	September 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Billing Update for HCPCS Code S3854 (Gene Expression Profiling Panel for Use in Management of Breast Cancer Treatment	September 2015
Physicians, Outpatient Hospital and Clinics	Billing Clarification: Aqueous Shunt (CPT-4 Code 66183)	September 2015
Physicians, Outpatient Hospital and Clinics	Policy Update for CPT-4 Code 36515 (Therapeutic Apheresis, w/Extracorporeal Immunoadsorption and Plasma Reinfusion	September 2015
ALL PROVIDERS	ICD-10 Update	August 2015
ALL PROVIDERS	2015 CPT-4/HCPCS Annual Update: Policy Updates	August 2015
ALL PROVIDERS	Policy Update: Management of Chronic Hepatitis C	August 2015
ALL PROVIDERS	Policy Update for Dynamic Adjustable Knee Extension (HCPCS Code E1810)	August 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Meningococcal B Vaccines (CPT-4 Codes 90620 & 90621)	July 2015
Anesthesiologists	Two New Anesthesia Modifiers - AA and QY	July 2015
Physicians, Outpatient Hospitals, Clinics and Oncologists	Policy Update for Various Chemotherapy Codes (HCPCS codes J0894, J9000, J9025, J9045, J9171)	July 2015
Physicians, Outpatient Hospitals, Clinics and Ophthalmologists	Policy Update for Bevacizumab 10 mg Injection (HCPCS code J9035)	July 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for "Manipulation Chest Wall" Codes (CPT-4 codes 94667 and 94668)	July 2015
DME, Orthotics and Prosthetics Providers	Policy Update for Dynamic Adjustable Knee Extension (HCPCS Code E1810)	July 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Rate Change for Laboratory and Pathology Services	June 2015
Physicians, Outpatient Hospitals, Clinics and Oncologists	New Benefit: Nivolumab (IgG4 Monoclonal Antibody) Under HCPCS Code J3590 (Unclassified Biologics)	June 2015
Physicians, Outpatient Hospitals, Clinics and Oncologists	New Benefit: Pembrolizumab 1 mg Injection (HCPCS Codes C9027)	June 2015
Physicians, Outpatient Hospitals, Clinics and Radiologists	Policy Update for Low Dose Computed Tomography (HCPCS Code S8032)	June 2015
Physicians, Outpatient Hospitals, Clinics and Ambulatory Surgical Centers	Policy Update for Dental Services Billable Under CPT-4 Code 41899	June 2015
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Intravenous Sedation and General Anesthesia Guidelines for Dental Procedures	June 2015
Physicians, Outpatient Hospitals, and Clinics	Policy Update for Quantitative or Semiquantitative Allergen Testing (CPT-4 86003)	June 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for CPT-4 Codes 86780 (Teponema Palladium) and 87502 (Influenza Virus)	June 2015
Physicians, Outpatient Hospitals, and Clinics	Diagnosis Update for Dexamethasone Intravitreal Implant (HCPCS Code J7312)	June 2015
Physicians, Outpatient Hospitals, and Clinics	Diagnosis Update for HLA Class I Typing, High Resolution, One Allele or Allele Group (CPT-4 Code 81381)	June 2015
Physicians, Outpatient Hospitals, and Clinics	Diagnosis Update for Leuprolide Acetate Injections (HCPCS Codes J1950 and J9217)	June 2015
Physicians, Outpatient Hospitals, and Clinics	Diagnosis Update for Fluocinolone Acetonide (HCPCS Code J7311)	June 2015
Vision Providers	Diagnosis Update for Specific Vision Care Service Codes	June 2015
DME, Orthotics and Prosthetics Providers	Updated Frequency Limits for DME, Orthotics and Prosthetics Codes	June 2015
Physicians, Outpatient Hospitals, Clinics, Laboratories and Radiologists	Modifier ZS to be Discontinued	May 2015
ALL PROVIDERS	ICD-10 Important Reminder	April 2015
ALL PROVIDERS	2015 CPT-4/HCPCS Annual Update	April 2015
ALL PROVIDERS	Contacting CenCal Health for Claims Inquiries	April 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Dalbavancin 10 mg Injection (HCPCS Code C9443)	April 2015
Physicians, Outpatient Hospitals and Clinics	ICD-9-CM Codes Eliminated (68.3, 68.5, & V39.21)	April 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Health and Behavior Assessment/Intervention Services (CPT-4 Codes 96150-96154)	April 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Ramucirumab 5 mg Injection (HCPCS Code C9025)	April 2015
Medical Transportation Providers	Medical Transportation Code Conversion	March 2015
Physicians, Outpatient Hospitals and Clinics	Billing Medroxyprogesterone Acetate Injection for Contraceptive Use (HCPCS Code J3490 with Modifier U8)	March 2015
Physicians, Outpatient Hospitals and Clinics	REMINDER - New NCCI-Associated Modifiers (XE, XP, XS, XU)	March 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Bevacizumab 10 mg Injection (HCPCS Code J9035)	March 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Azacitidine 1 mg Injection (HCPCS Code J9025)	March 2015
Obstetricians, Physicians, Outpatient Hospitals and Clinics	Policy Revised for Fetal Monitoring During Labor (CPT-4 Codes 59050 and 59051)	March 2015
Family Planning Providers	Medi-Cal Rate Increase for CPT-4 Codes 11981 and 58300	March 2015
Physicians, Outpatient Hospitals, Clinics, Laboratories	TAR Requirement for All Tier 2. Molecular Pathology Procedure Codes (CPT-4 Codes 81400-81408)	March 2015
DME Providers	Tax Status Update for DME, Orthotic and Prosthetic Codes	March 2015
ALL PROVIDERS	New Claim Correction Process	February 2015
ALL PROVIDERS	Frequently Asked Questions for New Claim Correction Process	February 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Octreotide Injections (HCPCS Codes J2353 and J2354)	February 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: Behaviorial Therapy for Cardiovascular Disease (HCPCS Code G0446)	February 2015
DME Providers	New Benefit: Bulking Agents for Treating Urinary Incontinence (HCPCS Code L8603 and L8606)	February 2015
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Molecular Pathology Procedure, Level 3 (CPT-4 code 81402)	February 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Denosumab 1 mg Injection (HCPCS Code J0897)	February 2015
Hospice Providers	Policy Update for Hospice Care Face-to-Face Encounters	February 2015
DME Providers	Rate Change for Specific DME Codes	February 2015
Physicians and Outpatient Hospitals	HIPAA Conversion and Billing Update for Organ Procurement Codes	February 2015
Physicians, Outpatient Hospitals and Clinics	New Benefit: 4 New NCCI Modifiers (XE, XP, XS and XU)	January 2015
DME Providers	New Benefit: Breast Pump Supplies (HCPCS Codes A4281-A4286)	January 2015
Physicians and Dialysis Clinics	Policy Update: Hepatitis B Tests Now Available for Dialysis Patients	January 2015
Physicians, Outpatient Hospitals and Clinics	Policy Update for Noninvasive Prenatal Testing for Fetal Aneuploidy	January 2015
ALL PROVIDERS	2015 EOB Check Dates	January 2015

ARCHIVE - 2014 Recent Billing/Policy Update Articles

Here you will find previously posted 2014 articles from the "Recent Billing/Policy Updates" section

Attention	ARCHIVED 2014 Recent Billing/Policy Update Articles	Original Posting Date
ALL PROVIDERS	Notification of 2015 CPT-4/HCPCS Codes	December 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Low-Dose Computer Tomography for Lung Cancer Screening (HCPCS Code S8032)	December 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Specific Surgery Codes	December 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Meningococcal Vaccine Benefit (HCPCS Code 90644)	December 2014
Oncologists	Policy Update for Breast Cancer Gene Expression Profiling (HCPCS Code S3854)	December 2014
Hospice Providers	Policy Update for Hospice Care Eligibility Requirements	December 2014
Allergists, Laboratories, Outpatient Hospitals and Clinics	Policy Update for Allergen Specific IgE (CPT-4 Code 86003)	December 2014
Ophthalmologists	Policy Update for Intravitreal Dexamethasone (HCPCS Code J7312)	December 2014
Physicians, Outpatient Hospitals, Clinics and Laboratories	Policy Update for Infectious Agent Detection (CPT-4 Code 87798)	December 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Two Vaccines that are No Longer Being Manufactured (CPT-4 Codes 90705 and 90706)	December 2014
ALL PROVIDERS	Introducing 2 New Claims Department Customer Service Representatives	November 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Signal-Averaged Electrocardiography [SAECG], with or without ECG (CPT-4 Code 93278)	November 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Vedolizumab 1 mg Injection (HCPCS Code C9026)	November 2014
Orthotics and Prosthetics Providers	New Benefit: Single and Double Knee Orthoses (HCPCS Codes K0901 and K0902)	November 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Mitroxantrone HCI, per 5 mg Injection (HCPCS Code J9293)	November 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Neonatal Hypothermia (CPT-4 Codes 99481 and 99482)	November 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Transluminal Balloon Angioplasty (CPT-4 Codes 75962)	November 2014
DME Providers	Reminder: Authorization and Billing Limit Requirements	November 2014
Physicians, Outpatient Hospitals and Clinics	Rate Reduction for Electrocardiograms (CPT-4 Codes 93000, 93005 and 93010)	November 2014
ALL PROVIDERS	ICD-10 Transition Checklist Available	October 2014
LTC FS/NF-B Providers	Interim Rates Established	October 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: HCPCS Codes S0144 (Propofol 10 mg Injection) and Q9974 (Morphine Sulfate 10 mg Injection)	October 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Brachytherapy (HCPCS Code C2644)	October 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Bevacizumab 10 mg Injection (HCPCS Code J9035)	October 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Amifostine 500 mg Injection (HCPCS Code J0207)	October 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Epirubicin HCI 2 mg Injection HCPCS Code J9178)	October 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Lumizyme 10 mg Injection (HCPCS Code J0221)	October 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Aflibercept 1 mg Injection (HCPCS Code J0178)	October 2014
Physicians, Outpatient Hospitals and Clinics	Frequency Limit Update for CPT-4 Codes 81507 and 81287 and 'Do Not Report' Update for HCPCS Codes G0461 and G0462	October 2014
ALL PROVIDERS	IMPORTANT REMINDER	September 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Dalbavancin, Billable under HCPCS Code J3490 (unclassified drugs)	September 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Dexamethasone Intravitreal Implant (HCPCS Code J7312)	September 2014
Laboratories	Policy Update for Tier 2 Molecular Pathology Procedure (CPT-4 Code 81400)	September 2014
ALL PROVIDERS	ICD-10 Update	August 2014
ALL PROVIDERS	CMS 1500 Update	August 2014
ALL PROVIDERS	2014 CPT-4/HCPCS Annual Update: TAR and ICD-9-CM Codes	August 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Vedolizumab, Billable under HCPCS Code J3590 (unclassified biologics)	August 2014
Surgeons	Policy Update for Surgery Reimbursement	August 2014
Laboratories	Policy Update for Tissue Culture (CPT-4 Codes 88230 and 88235)	August 2014
Obstetricians	Clarification of "Pregnancy Related" Term	August 2014
Hospice Providers	Clarification of Appropriate Diagnoses for Hospice Claims	August 2014
Physicians and Outpatient Hospitals	Hyperbaric Oxygen Therapy (HBO): Change to Billing and TAR Requirements	August 2014
ALL PROVIDERS	2014 CPT-4/HCPCS Codes: Additional Information	July 2014
ALL PROVIDERS	CMS 1500 Billing Update	July 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Cystourethroscopy (HCPCS Codes C9739 and C9740)	July 2014
PCPs	New Benefit: Meningococcal Conjugate Vaccine (CPT-4 Code 90644)	July 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Obinutuzumab (HCPCS Code C9021)	July 2014
Family Planning Providers	Policy Update for Contraceptive Supply, Condoms (HCPCS Codes A4267 and A4268)	July 2014
Family Planning Providers	Policy Update for RN Dispensing and Administration of Hormonal Contraceptives	July 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Sargramostim [GM-CSF] 50 mg Injection (HCPCS Code J2820)	July 2014
PCPs and Obstetricians	Policy Update for CPT-4 Code 90715 (TDaP Vaccine)	July 2014
Radiology Providers	Policy Reminder for Positron Emission Tomography (PET) Scans	July 2014
Orthotics and Prosthetics Providers	Definition of Custom-Fabricated Orthotics	July 2014
DME, Orthotics and Prosthetics Providers	Policy Clarification for Shipping and Handling of DME, Orthotics and Prosthetics	July 2014
Laboratory and Pathology Providers	Delayed: Discontinuation of Split Billing for Specific Laboratory and Pathology Codes	June 2014
Physicians	New Benefit: Tbo-Filigrastim 5 mcg Injection (HCPCS Code J1446)	June 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update: Bendamustine HCL 1 mg Injection (HCPCS Code J9033)	June 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Ecallantide (HCPCS Code J1290)	June 2014
DME Providers	Policy Clarification for DME Date of Service	June 2014
PCPs	Policy Update for Meningococcal Vaccine (HCPCS Code 90644)	May 2014
ALL PROVIDERS	Policy Information for 2014 CPT-4/HCPCS Annual Update	May 2014
Oncologists	Policy Update for Gemcitabine HCI 200 mg (HCPCS Code J9201) and Ifosfamide 1 gm Injection (HCPCS Code J9208)	May 2014
PCPs	Policy Update for Influenza Vaccines (HCPCS Codes 90672, 90685, 90686 and 90688)	May 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Omalizumab 5 mg Injection (HCPCS Code J2357)	May 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Paclitaxel 30 mg Injection (HCPCS Code J9310)	May 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update for Ziprasidone Mesylate 10 mg Injection (HCPCS J3486)	May 2014
DME, Orthotics and Prosthetics Providers	Policy Update for "By Report" Orthotics and Prosthetics Pricing	May 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Pemetrexed 10 mg Injection (HCPCS Code J9035)	May 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Rituximab 100 mg Injection (HCPCS Code J9310)	May 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Topotecan 0.1 mg Injection (HCPCS Code J9351)	May 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Verteprofin 0.1 mg Injection (HCPCS Code J3396)	May 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Vitamin B-12 Cyanocobalamin, up to 1000 mg Injection (HCPCS Code J3420)	May 2014
DME Providers	HCPCS Code K0900 - No Longer Medi-Cal Benefit	May 2014
Laboratory and Pathology Providers	Discontinuation of Split Billing for Specific Laboratory and Pathology Codes	May 2014
ALL PROVIDERS	ICD-10 Implementation Delayed	April 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update: Aldesleukin Injection (HCPCS Code J9015)	April 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Loxapine Inhalation Powder (HCPCS Code C9497)	April 2014
PCPs	New Benefit: Meningococcal Vaccine (HCPCS Code 90644)	April 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Ocriplasmin 0.125 mg Injection (HCPCS Codes J7316/C9298)	April 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Aripiprazole Extended Release (HCPCS Code J0401)	April 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Ado-Trastuzumab Emtansine 1 mg Injection (HCPCS Codes J9354/C9131)	April 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Carfilzomib 1 mg Injection (HCPCS Codes J9047/C9295)	April 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Taliglucerase Alfa 10 units Injection (HCPCS Codes J3090/C9294)	April 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Non-Benefit - Sermorelin Acetate 1 mcg Injection (HCPCS Code Q0515)	April 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Tositumomab Discontinued (HCPCS Codes G3001, A9544 and A9545)	April 2014
Physicians, Outpatient Hospitals and Clinics	Rate Update: Apheresis Services (HCPCS Codes 36511-36516, 38205 and 38206)	April 2014
ALL PROVIDERS	ICD-10 Update: Preparation Tools and Tips	March 2014
Oncologists	New Benefit: Vincristine Sulfate Liposome Injection (HCPCS Code J9371)	March 2014
Oncologists	New Benefit: Pertuzumab 1 mg Injection (HCPCS Code J9306)	March 2014
Rheumatologists	New Benefit: Certolizumab Pegol 1 mg Injection (HCPCS Code J0717)	March 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Adenosine Injection (HCPCS Code J0151)	March 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Bivigam Injection, Immune Globulin 500 mg (HCPCS Code J1556)	March 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Golimumab 1 mg Injection (HCPCS Code J1602)	March 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Zoledronic Acid 1 mg Injection (HCPCS Code J3489)	March 2014
Audiologists	Policy Update: Hearing Aid Reimbursement Rates	March 2014
DME Providers	Policy Update: TAR Documentation for Apnea Monitors (HCPCS Codes E0618 and E0619)	March 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Diagnosis Restrictions for Tumor Antigens (CPT-4 Code 86304)	March 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Patient Age Restrictions for Tuberculosis Tests (CPT-4 Codes 86480 and 86481)	March 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Invoice No Longer Required for Low Osmolar Contrast Material (HCPCS Codes Q9965-Q9967)	March 2014
ALL PROVIDERS	New Fax # for the Claims Department	February 2014
Physicians and Psychologists	New Benefit: Screening, Brief Intervention and Referral to Treatment for Alcohol Misuse (HCPCS H0049 and H0050)	February 2014
PCPs	New Benefit: Flublok RIV3 (CPT-4 90673)	February 2014
Inpatient Hospitals	Benefit Expansion: Voluntary Inpatient Detoxification	February 2014
Physicians, Outpatient Hospitals and Clinics	New Emergency Contraceptive Benefit: Ulipristal Acetate (Ella 30 mg) Billable under J3490 U5	February 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Filgrastim [G-CSF] 1 mcg Injection (HCPCS Code J1442)	February 2014
Physicians, Outpatient Hospitals and Clinics	Diagnosis Update for Biochemical Assays (CPT-4 Codes 81508 and 81511)	February 2014
Physicians, Outpatient Hospitals and Clinics	Policy Update: Quantity of Units Increase for Various Medications	February 2014
Medical Ground and Air Transportation Providers	Policy Update for Billing "Dry Run" Claims	February 2014
ALL PROVIDERS	ICD-10: New Claim Form Highlights and New Survey	January 2014
Physicians, Outpatient Hospitals and Clinics	New Benefit: Ferric Carboxymaltose (HCPCS Code C9441)	January 2014
Radiology Providers	New Benefit: Radium Ra 223 Dichloride (HCPCS Code A9699)	January 2014
Physicians, Outpatient Hospitals and Clinics	New Benefits and Age Restrictions for Virus Vaccines (HCPCS 90685, 90686 and 90688)	January 2014

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