Back to dashboard
MedicaidBilling CodesHigh impact

AHCCCS DFSM Claims Clues - August 2015

Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Aug 1, 2015
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS is transitioning from ICD-9 to ICD-10 diagnosis codes effective October 1, 2015, and adding adult orthotics coverage for ages 21+ with prior authorization requirements effective August 1, 2015. All claims with ICD-9 codes will be rejected after the transition date.

Action Required

Action needed
By October 1, 2015: Billing team must update all systems to use ICD-10 diagnosis codes instead of ICD-9. Verify billing software supports 3-7 character ICD-10 codes and will reject ICD-9 submissions. For adult orthotics (age 21+): Obtain prior authorization before providing services, ensure physician/PA/NP prescription, and document medical necessity per Medicare guidelines. Claims with ICD-9 codes after 10/1/15 will be rejected and timely filing will not begin until compliant claims are resubmitted.