Since Medi-Cal made the changes in 6/2016. I am having issues getting some of my claims paid.
Ex: If a patient only has Medi-Cal and I bill routine care services on one claim and bill room and board on a separate claim the room and board gets denied for RAD 0168 ( More than one type of hospice care not payable for any recipient on the same or overlapping dates of service) however these are two different types of service.
We never had any problems getting these paid until Medi-Cal eliminated the use of HCPC codes for hospice.
Another issue, if a patient has Medicare part B only, Medi-Cal pays for routine hospice care, no need for a denial (per their manual) however they are denying requesting the medicare denial.