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MedicaidPrior AuthHigh impact

21-558 Medical Policies - 2nd Quarter 2021

Health Net·CA · Psychiatry, Neurology, Cardiology +7 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health (Medi-Cal) updated multiple medical policies for Q2 2021, affecting prior authorization requirements, billing codes, and coverage criteria across numerous specialties. Key changes include updated CPT codes for ADHD testing, nerve studies, and spinal procedures, plus revised criteria for gender-affirming procedures, pain management, and wound care.

Action Required

Action needed
Immediately: Billing team must update system to reflect new CPT codes - remove deleted codes 92585 and 92586, add replacement codes 92650-92653 for auditory evoked potential testing. Update prior authorization requirements for ADHD assessments to exclude ECG codes 93000, 93005, 93010 and lipid panel codes 80061, 83718, 83719, 82721, 83722, 84475 when billed with sole ADHD diagnosis. Review and update prior authorization criteria for gender-affirming procedures, spinal cord stimulation psychological evaluations, and wound care skin substitutes using updated HCPCS codes.

Affected Billing Codes

93000
93005
93010
80061
83718
83719
82721
83722
84475
92585
92586
92650
92651
92652
92653
E0316
E1399
E0328
E0329
L03.319
L03.818
L98.499
Q4150
Q4183
Q4190
Q4208
Q4209
Q4210
Q4211
Q4212
Q4213
Q4214
Q4215
Q4216
Q4217
Q4218
Q4219
Q4220
Q4221
Q4222
Q4223
Q4224
Q4225
Q4226
Q4176
Q4237
Q4238
Q4239
K52.0
K72.00
K72.91
K85.01
K85.02
K85.11
K85.12
K85.31
K85.32
K85.81
K85.82
K85.91
K85.92
Z76.82
K1020
Z74.01
Z74.3
Z78.1
Z99.89