MDHHS has noticed multiple claim denials when providers are billing for clinical trials utilizing the diagnosis code Z006. This serves as a reminder that every claim billed for a beneficiary in a clinical trial where diagnosis code Z006 is utilized must include the Attestation Form (BPHASA-2210) along with necessary supporting documentation. The supporting documentation should be uploaded to the CHAMPS Document Management Portal (DMP), and a claim note stating “Documents within DMP”. Claims will be denied if any or all documents are not included, or the claim does not contain a claim note.
For additional information including where to find the Attestation Form, and what supporting documentation is needed refer to the Medicaid Provider Manual, Billing and Reimbursement for Institutional Providers Chapter, Section 6.3 Clinical Trials or Billing and Reimbursement for Professional Providers Chapter, Section 6.8 Clinical Trials.
Providers with further questions should contact Provider Support at 1-800-292-2550 or by email at ProviderSupport@Michigan.gov.