Medical Supplies
References
Medical Supplies: Medical Supply Provider Workshops
October 31, 2008
Effective for dates of services on or after April 1, 2009, billing for medical supplies will be subject to new requirements:
- Incontinence and disposable medical supplies must be billed with Healthcare Common Procedure Coding System (HCPCS) Level II codes.
- This conversion effort will not impact existing billing and coding requirements for medical supplies billed as “pharmacy only” benefits on the NCPDP claim transaction standards.
- The Universal Product Number (UPN) will be required on claims for all contracted incontinence and disposable medical supplies.
- Pharmacy claims for incontinence and disposable medical supplies must be submitted using the ASC X12N 837P 4010A1 format or the CMS-1500 claim form.
To assist and inform providers about these new requirements, Medi-Cal will host workshops in January and February 2009 that will cover the following topics:
- Background information
- Summary of new requirements
- Billing changes effective April 1, 2009
- Changes to the Treatment Authorization Request (TAR)
- Claim processing information specific to the medical supplies billing requirements
The provider workshops will be offered throughout California and will be announced on the Medi-Cal Education & Outreach Training Seminars page once the dates and locations are finalized. Providers will be able to call the Telephone Service Center (TSC) at 1-800-541-5555 to register for the workshops.
Providers are encouraged to review all the information currently available in the monthly Medi-Cal Update online and on the Medical Supplies Billing Requirements Overview page located in the “References” area of the Medi-Cal Web site.