MedicaidCoverageMedium impact
AHCCCS DFSM Claims Clues - March 2018
Arizona Medicaid - AHCCCS·AZ · Gastroenterology, Occupational Therapy, Psychiatry·Claims & Billing
Effective date
Apr 1, 2018
We identified it
Jun 17, 2026
Summary
AHCCCS removed fibrosis level requirements for Hepatitis C Direct Acting Antiviral medication prior authorization effective 1/1/2018. Occupational therapy coverage expanded to members 21+ with 15 rehabilitative visits per contract year starting 10/1/2017. New demographic data collection using ICD-10 Social Determinants of Health codes begins 4/1/2018.
Action Required
By April 1, 2018: Providers with ICD-10 coding capabilities must begin using Social Determinants of Health diagnosis codes on applicable claims. Update billing systems to remove fibrosis level requirements for Hepatitis C DAA prior authorizations (effective 1/1/2018). Begin billing occupational therapy for members 21+ with 15 visits per contract year limit (effective 10/1/2017). Prepare for new online demographic data portal launching 10/1/2018.