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Miscellaneous Coding Policies

Provider Type

  • Physicians

Counties Covered

  • Fresno
  • Kern  
  • Kings
  • Los Angeles
  • Madera
  • Sacramento
  • San Diego 
  • San Joaquin
  • Stanislaus
  • Tulare

Health Net maintains a list of coding edits that are not directly sourced to the American Medical Association (AMA) CPT guidelines or to the Centers for Medicare and Medicaid Services (CMS) National Correct Coding Initiative (CCI) edits effective for the current quarter. Select one of the following as applicable:

Health Net automatically updates its edit logic to reflect additions, changes and deletions to CMS CCI edits on a quarterly basis corresponding to the CMS release, unless otherwise notified in the View Changes Memo of the Provider Library.

Last Updated: 10/30/2019