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AHCCCS DFSM Claims Clues - November 2017

Arizona Medicaid - AHCCCS·AZ · Podiatry, Family Medicine, Internal Medicine +1 more·Claims & Billing
Effective date
Oct 1, 2017
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS expanded podiatric services to include limited amputations of partial foot and toe as of October 1, 2017, and implemented new face-to-face encounter requirements for home health services and medical equipment orders effective October 1, 2017. Podiatry claims must include ordering provider information in fields 17 and 17b or will be denied.

Action Required

Action needed
Immediately: Billing team must ensure all podiatry service claims include the ordering provider's name with qualifier DK in field 17 and ordering provider's NPI in field 17b on CMS 1500 forms. Claims missing this information will be denied. For home health services and medical equipment orders, verify face-to-face encounters occurred within required timeframes (90 days prior or 30 days after for home health; 60 days prior for equipment).