MedicaidDocumentationMedium impact
AHCCCS DFSM Claims Clues - May 2025
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
May 1, 2025
We identified it
Jun 17, 2026
Summary
AHCCCS has updated behavioral health claims documentation requirements, emphasizing the need to review documentation before submission to prevent denials like MD418 'Claim Mismatch Units/Code Documented'. The policy also clarifies that providers should not void/replace claims when only documentation is requested - instead upload documents via EDI Solutions portal within 48 hours.
Action Required
Immediately: Behavioral health billing staff must review all documentation and claim specifics before submission to prevent MD418 denials. When documentation is requested post-submission, upload required documents via EDI Solutions portal within 48 hours and submit service ticket for claim review - do not void/replace the original claim. When using AHCCCS CRN as document attachment number, enter only first 12 digits excluding service line numbers like 001/002.