CHA News Article

Timeliness Date Extended for Resubmission of Medi-Cal DRG Claims Over 22 Lines

Providers who wish to resubmit Medi-Cal diagnosis-related group (DRG) claims that exceed 22 lines may do so until Feb. 1. Providers should complete a claims inquiry form to void paid claims that were split-billed due to the 22-line restriction before July 28, 2014, where one of the following criteria applies:

  • First page paid, second page denied; or
  • Second page paid, first page denied; or
  • First and second pages paid separately.

Once the void appears on a future remittance advice details form, the claims may be resubmitted as a single claim.

For additional information about recent updates to electronic transactions, including specific processing instructions for inpatient claims submitted with more than 22 claim lines, providers should refer to the HIPAA 5010 Medi-Cal Companion Guide Update article.