Medi-Cal EPC Letter – Reprocessing of Claims for Select ICD-10 Diagnosis Codes

The Department of Health Care Services (DHCS) implemented system changes to update International Classification of Diseases, Tenth Revision (ICD-10)-CM and ICD10-Procedure Coding System (PCS) to ICD, Ninth Revision (ICD-9) backward map crosswalk for select codes, effective retroactively for dates of service on or after October 1, 2021. This retroactive policy update requires voiding and resubmission of erroneously paid claims.

No action is required on your part. The California Medicaid Management Information System (MMIS) Fiscal Intermediary will void and resubmit the affected claims. These voids will appear on Remittance Advice Details (RAD) forms beginning May 19, 2022 with RAD code 0819: Void and resubmit of claims processed in error. Corresponding resubmits will appear on RAD forms beginning May 26, 2022.

Source: https://files.medi-cal.ca.gov/pubsdoco/epc/2022/31326_02_p43608.pdf