CHA News

DHCS Adds New COVID-19-Related Codes to the Diagnosis-Related Group Methodology, Retroactively to April 1

This post has been archived and contains information that may be out of date.

The Department of Health Care Services (DHCS) recently announced the incorporation of new Centers for Medicare & Medicaid Services-approved ICD-10-CM and ICD-10-PCS codes related to COVID-19 into the diagnosis-related group inpatient hospital payment methodology, retroactively to April 1.   

The following diagnosis and procedure codes will now be reflected in the methodology of determining a hospital’s specific bundled episodic rate: 

Diagnostic Codes
Z28.310 
Z28.311 
Z28.39 
Procedure Codes
XW013V7 
XW013W7 
XW023V7
XW023W7
XW023X7
XW023Y7 
XW0DXR7 
XW0G7R7 
XW0H7R7 

An erroneous payment correction will be implemented to reprocess affected claims with dates of service on or after April 1, 2022. Providers may also elect to correct and resubmit previously denied claims as described in theCIF Submission and Timeliness Instructions section of the Medi-Cal Provider Manual.