<p>Obstetrics Contents PART 2 – MEDI-CAL BILLING AND POLICY</p><p>The Contents is a list of sections contained in the Part 2 manual, General Medicine for Obstetrics. Section titles appear in alphabetical order. The “locator key” is an abbreviated form of the section title at the top of each page for skimming and identifying sections. For detailed topic entries within Part 1 and Part 2, refer to the Manual Index in the Indexes and Glossary manual.</p><p>Section Title Locator Key</p><p>A</p><p>Abortions...... abort Alternative Birthing Centers...... altern Anesthesia...... anest Anesthesia Billing Examples: CMS-1500...... anest cms Appeal Form Completion...... appeal form</p><p>C</p><p>California Children’s Services (CCS) Program...... cal child California Children’s Services (CCS) Program Approved Hospitals...... cal child appr</p><p>California Children’s Services (CCS) Program Billing...... cal child bil CCS Program Billing Guidelines California Children’s Services (CCS) Program Billing Example: CMS-1500...... cal child bil cms California Children’s Services (CCS) Program County Office Directory.....cal child county California Children’s Services (CCS) Program Eligibility...... cal child elig California Children’s Services (CCS) Program Medical Therapy Program...... cal child med California Children’s Services (CCS) Program Provider Paneling...... cal child panel Individual Provider Paneling Application for Physicians and Podiatrists Individual Provider Paneling Application for Allied Health Care Professionals California Children’s Services (CCS) Program Referrals...... cal child ref</p><p> continued</p><p>2 – Contents for OB Billing and Policy i Medical Services – Obstetrics 394 May 2007 Section Title Locator Key</p><p>C</p><p>California Children’s Services (CCS) Program Service Authorization Request (SAR)...... cal child sar New Referral CCS/GHPP Client Service Authorization Request (SAR) Established CCS/GHPP Client Service Authorization Request (SAR) CCS/GHPP Discharge Planning Service Authorization Request (SAR) California Children’s Services (CCS) Program Service Code Groupings...... cal child ser California Children’s Services (CCS) Program Special Care Centers...... cal child spec Child Health and Disability Prevention (CHDP) Program...... child CIF Completion...... cif co CIF Special Billing Instructions...... cif sp CIF Submission and Timeliness Instructions...... cif sub CMS-1500 Completion...... cms comp CMS-1500 Special Billing Instructions...... cms spec CMS-1500 Submission and Timeliness Instructions...... cms sub CMS-1500 Tips for Billing...... cms tips Contracted Inpatient Services for Medical Services...... cont ms Correct Coding Initiative: National...... correct Correct Coding Initiative: National – Claim Preparation...... correct cod</p><p>D</p><p>Dental Benefits...... dental Drug Use Review (DUR) Program...... drug Drugs: Contract Drugs List Part 5 – Authorized Drug Manufacturer Labeler Codes...... drugs cdl p5</p><p>2 – Contents for OB Billing and Policy ii Medical Services – Obstetrics 470 August 2013 Section Title Locator Key</p><p>E</p><p>Evaluation & Management (E&M)...... eval Every Woman Counts...... ev woman Every Woman Counts Billing Examples: CMS-1500...... ev woman exc</p><p>F</p><p>Family Planning...... fam planning Family Planning Billing Example: CMS-1500...... fam planning cms Forms: Legibility and Completion Standards...... forms leg Forms Reorder Request: Guidelines...... forms reo Forms Reorder Request: Medical Services and Allied Health...... forms reo ma</p><p>G</p><p>Genetic Counseling and Screening...... gene coun Genetic Screening Billing Examples: CMS-1500...... gene ex Genetically Handicapped Persons Program (GHPP)...... genetic</p><p>H</p><p>HCPCS Introduction...... hcpcs HCPCS Level III Interim Code List: Reimbursable Medi-Cal-Only Codes...... hcpcs iii Hysterectomy...... hyst</p><p>2 – Contents for OB Billing and Policy iii Medical Services – Obstetrics 479 May 2014 Section Title Locator Key</p><p>I</p><p>Immunizations...... immun Immunizations Code List...... immun cd Injections: An Overview...... inject an over Injections: Billing Example for CMS 1500...... inject bil cms Injections: Code List...... inject cd list Injections: Drugs A-D Policy...... inject drug a-d Injections: Drugs E-H Policy...... inject drug e-h Injections: Drugs I-M Policy...... inject drug i-m Injections: Drugs N-R Policy...... inject drug n-r Injections: Drugs S-Z Policy...... inject drug s-z Injections: Hydration...... inject hydra</p><p>M</p><p>Medi-Cal List of Contract Drugs...... medi con access on Internet at www.medi-cal.ca.gov Medicare/Medi-Cal Crossover Claims: CMS-1500...... medi cr cms Medicare/Medi-Cal Crossover Claims: CMS-1500 Billing Examples for Medical Services...... medi cr cms exm Medicare/Medi-Cal Crossover Claims: Medi-Cal Pricing Examples for Medical Services...... medi cr cms prm Medicare Non-Covered Services: Charts Introduction...... medi non cha Medicare Non-Covered Services: CPT-4 Codes...... medi non cpt Medicare Non-Covered Services: HCPCS Codes...... medi non hcp Medicare Procedures: Medi-Cal Code Correlation List...... medi pro med Minor Consent Program...... minor Modifiers...... modif Modifiers: Approved List...... modif app Modifiers Used With Procedure Codes...... modif used</p><p>2 – Contents for OB Billing and Policy iv Medical Services – Obstetrics 479 May 2014 Section Title Locator Key</p><p>N</p><p>Non-Injectable Drugs...... non inject Non-Physician Medical Practitioners (NMP)...... non ph Non-Physician Medical Practitioners (NMP) Billing Example: CMS-1500...... non ph cms</p><p>O</p><p>Once-in-a-Lifetime Procedure Codes...... once Optional Benefits Exclusion...... opt ben exc Other Health Coverage (OHC)...... oth hlth Other Health Coverage (OHC): CPT-4 and HCPCS Codes...... oth hlth cpt</p><p>2 – Contents for OB Billing and Policy v Medical Services – Obstetrics 479 May 2014 Section Title Locator Key</p><p>P</p><p>Pathology: An Overview of Enrollment and Proficiency Testing Requirements...... path an over Pathology: Billing and Modifiers...... path bil Pathology Billing Example: CMS-1500...... path bil cms Pathology: Blood Collection and Handling...... path blood Pathology: Blood Collection and Handling Billing Examples – CMS-1500...... path blood ex Pathology: Chemistry...... path chem Pathology: Cytopathology...... path cyto Pathology: Drug Testing...... path drug Pathology: Immunology...... path immun Pathology: Microbiology...... path micro Pathology: Molecular Pathology...... path molec Pathology: Organ or Disease-Oriented Panels...... path organ Pathology: Surgical...... path surg Pathology: Urinalysis...... path urin Physician-Administered Drugs – NDC...... physician ndc Physician-Administered Drugs – NDC: CMS-1500 Billing Instructions.....physician ndc cms Pregnancy: Comprehensive Perinatal Services Program (CPSP)...... preg com Pregnancy: Comprehensive Perinatal Services Program (CPSP) Billing Examples – CMS-1500...... preg com exc Pregnancy: Comprehensive Perinatal Services Program (CPSP) List of Billing Codes...... preg com lis Pregnancy Determination...... preg determ</p><p> continued</p><p>2 – Contents for OB Billing and Policy vi Medical Services – Obstetrics 479 May 2014 Section Title Locator Key</p><p>P</p><p>Pregnancy: Early Care and Diagnostic Services...... preg early Pregnancy Examples: CMS-1500...... preg ex cms Pregnancy: Fetal Monitoring, Labor and Delivery Services...... preg fetal Pregnancy: Global Billing...... preg glo Pregnancy: Global Billing Codes...... preg glo cd Pregnancy: Per-Visit Billing...... preg per Pregnancy: Per-Visit Billing Codes...... preg per cd Pregnancy: Postpartum and Newborn Referral Services...... preg post Pregnancy: Share of Cost...... preg share Presumptive Eligibility for Pregnant Women...... presum Presumptive Eligibility for Pregnant Women Provider Fact Sheet (MC 286 form) Directions to Apply for Medi-Cal (MC 266 form) Forms Order – Presumptive Eligibility (PE) for Pregnant Women Program (MC 285 form) Patient Directions for Presumptive Eligibility for Pregnant Women Program Application (MC 265 form) Patient Directions for Presumptive Eligibility Application (MC 265 form) (Spanish) Qualified Provider Application for Presumptive Eligibility Participation and Presumptive Eligibility Qualified Provider Responsibilities and Agreement (MC 311 form) Statement of California Residency (Supplement to Application for Presumptive Eligibility Only – MC 263-SR) (form) Statement of California Residency (Supplement to Application for Presumptive Eligibility Only – MC 263 S-R) (Spanish form) Explanation of Ineligibility for Presumptive Eligibility for Pregnant Women Program (MC 267 form) Weekly Presumptive Eligibility(PE) for Pregnant Women Enrollment Summary (MC 283 form) Presumptive Eligibility for Pregnant Women Program Process...... presum proc</p><p> continued</p><p>2 – Contents for OB Billing and Policy vii Medical Services – Obstetrics 515 May 2017 Section Title Locator Key</p><p>P</p><p>Presumptive Eligibility for Pregnant Women Provider Enrollment Instructions...... presum prov Presumptive Eligibility for Pregnant Women Provider Enrollment Checklist (form) Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry)...... prov bil</p><p>R</p><p>Radiology...... radi Radiology Billing Examples: CMS-1500...... radi bil cms Radiology: Diagnostic...... radi dia Radiology: Diagnostic Ultrasound...... radi dia ult Radiology: Nuclear Medicine...... radi nuc Radiology: Oncology...... radi onc Rates: Maximum Reimbursement...... rates max Rates: Maximum Reimbursement for Laboratories...... rates max lab Remittance Advice Details (RAD)...... remit adv Remittance Advice Details (RAD) Examples: Allied Health and Medical Services...... remit ex am Remittance Advice Details (RAD): Payments and Claim Status...... remit pay Resubmission Turnaround Document (RTD) Completion...... resub comp</p><p>S</p><p>Share of Cost (SOC): CMS-1500...... share cms Sign Language Interpretation...... sign Sterilization...... ster Supplies and Drugs...... supp drug Supplies and Drugs for Medical Services...... supp drug ms Surgery...... surg Surgery Billing Examples: CMS-1500...... surg bil cms Surgery: Billing With Modifiers...... surg bil mod Surgery: Female Genital System...... surg female Surgery: Laparoscopy and Hysteroscopy...... surg lap Surgery: Male Genital System...... surg male Surgery: Urinary System...... surg urin</p><p>2 – Contents for OB Billing and Policy viii Medical Services – Obstetrics 513 March 2017 Section Title Locator Key</p><p>T</p><p>TAR and Non-Benefit: Introduction to List...... tar and non TAR and Non-Benefit List: Codes 10000 – 19999...... tar and non cd1 TAR and Non-Benefit List: Codes 20000 – 29999...... tar and non cd2 TAR and Non-Benefit List: Codes 30000 – 39999...... tar and non cd3 TAR and Non-Benefit List: Codes 40000 – 49999...... tar and non cd4 TAR and Non-Benefit List: Codes 50000 – 59999...... tar and non cd5 TAR and Non-Benefit List: Codes 60000 – 69999...... tar and non cd6 TAR and Non-Benefit List: Codes 70000 – 79999...... tar and non cd7 TAR and Non-Benefit List: Codes 80000 – 89999...... tar and non cd8 TAR and Non-Benefit List: Codes 90000 – 99999...... tar and non cd9 TAR Completion...... tar comp TAR Deferral/Denial Policy (Frank v. Kizer)...... tar defer TAR Field Office Addresses...... tar field TAR Submission: Transmittal Form...... tar submis TAR: Submitting Appeals...... tar submit Transgender Services...... transgender Tuberculosis Program...... tuber</p><p>V</p><p>Vaccines For Children (VFC) Program...... vaccine</p><p>2 – Contents for OB Billing and Policy ix Medical Services – Obstetrics 517 July 2017</p>