Inappropriate Medi-Cal Denials on Gadolinium Code
Medi-Cal converted to 2008 CPT and HCPCS effective 9/1/08. In the July bulletin, they gave the following chart for converting deleted codes to new codes. Unfortunately, they did not get the crossover correct for the everyday gadolinium supply used with MRI. They left off A9579 (Injection, gadolinium based magnetic resonance contrast agent, not otherwise specified, per ml) which is what the majority of the radiology practices use to replace Q9952.
RADIOLOGY
Deleted and Replacement Codes
Deleted Code(s) Replacement Code(s)
A9565 A9572
Q9945, Q9946 Q9965
Q9947, Q9948 Q9966
Q9949, Q9950 Q9967
Q9952 A9576 - A9578
74350 49440
78615 Use other existing code(s)
We were contacted by a radiology billing manager and brought the issue to the attention of the DHCS. We were notified today that Procedure code A9579 is being added as a benefit retroactive to September 1, 2008. Previously denied claims, with a date of service of September 1, 2008 and later, will be automatically reprocessed. The change should be reflected in the December Provider Bulletin.
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