Confidential Screening/Billing Report (PM 160) Claim Form ...
ICD-10-CM diagnosis code in the Comments/Problems area. Code 4. ... but you have advised the parents to obtain the annual preventive dental care for a Medi-Cal child. Annual referrals begin at age 3 or earlier, if necessary, for maintenance of dental health. ... 10 Confidential Screening/Billing Report (PM 160) CHDP 131. Claim Form: Completion ... ................
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