01Already effective October 1, 2020: Emergency medical service providers bill the flu vaccine and its administration as a separate service on a separate claim form, not as part of a transport and not with ALS or BLS transport codes, at the AHCCCS FFS fee schedule rate.
02Hospitals: bill LARC devices on a CMS 1500 claim with the appropriate HCPCS code and procedure code 58300 for IUD insertion to be reimbursed separately from the APR-DRG payment.
03There is no ICD-10 PCS code for the LARC device for inpatient hospital use, so AHCCCS pays hospitals for the device in addition to the DRG payment; see Chapter 11 Addendum of the FFS Provider Billing Manual.
04Billing team: for claim corrections, resubmit electronically as a new claim, use Lucinda Console size 10 font, and do not use white out or correction tape on paper claims.
05Billing team: submit medical records, the Daily Trip Report and other supporting documents through the Transaction Insight Portal, the preferred method, because DFSM may require documentation for certain services.
06Providers rendering services to an AHCCCS member must be located within the United States or a US territory and be AHCCCS registered to be reimbursed.
07Providers who are not registered with AHCCCS but may be the Referring, Ordering, Prescribing or Attending provider must enroll Previously due January 1, 2021 (date passed; verify current applicability).
08Behavioral health air transport: clinical documentation must indicate why ground transport is not sufficient, what care the member requires during transport, what type of care the member is being transferred for, and, when applicable, why travel beyond the nearest appropriate facility is medically necessary.
09Transport services may be pended or denied when inappropriate modes or types of transport are used, and emergency transportation does not require prior authorization.
10Providers: use the CR modifier on all claims for services related to COVID-19.
11Claims for AIHP and TRBHA members should be sent to AHCCCS DFSM.