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Include FFS in the Claim Note segment for relevant taxonomy codes

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Claim Requirement 5.10.0

When a service is rendered by a Fee-for-Service Medi-Cal (FFS/MC) individual or group provider, the claim must include FFS in the Claim Note segment and the first three digits of the rendering provider’s taxonomy code must be 103, 104, 106, 163, 193, 207, 208, 363, or 364.

Short Doyle/Medi-Cal (SD/MC), the medical claiming system, will deny the service line if the Claim Note Segment contains FFS and the first three digits of the rendering provider’s taxonomy code does not start with 103, 104, 106, 163, 193, 207, 208, 363, or 364.

Note: It is recommended to use File Import for large batches of providers.

  1. Go to: myAvatar PM > System Maintenance > System Definition > Practitioner Numbers by Guarantor and Program.
  2. Select the Practitioner and select the Add Practitioner Numbers tab.
  3. Select (800) Medi-Cal for the Guarantor ID. 
  4. Enter 07/01/2023 for the Effective Date.
  5. For 837 Professional claims:
    1. Claim Note Reference Code (837P-2300-NTE-01) - select the Additional Information dictionary
    2. Claim Note Text (837P-2300-NTE-02) - enter FFS
  6. For 837 Institutional claims:
    1. Claim Note Reference Code (837I-2300-NTE-01) - select the Additional Information dictionary
    2. Claim Note Text (837I-2300-NTE-02) - enter FFS
  7. Select Submit.
► Example

clipboard_e9a27b895f79e8820c0595c17593c6bda.png

 The FFS segment is now added to the 837.

clipboard_e67c6b353c86469968dbc04adb6765198.png