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AHCCCS DFSM Claims Clues - March 2015

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

Summary

AHCCCS (Arizona Medicaid) has implemented several billing code changes effective April 1, 2015, including new pharmacy modifiers JF and EX, replacing modifier 80 with AS for certain provider types, adding new injection code Q9975 for Factor VIII, and changing FQHC/RHC reimbursement to per-claim PPS rates instead of fee-for-service with annual reconciliation.

Action Required

Action needed
By April 1, 2015: Billing team must update system to add new pharmacy modifiers JF (compounded drug) and EX (expatriate beneficiary) to forms RF114 and RF119. Replace modifier 80 with modifier AS for certified nurse midwives (09), physician assistants (18), registered nurse practitioners (19), and surgical first assistants (82). Add new injection code Q9975 for Factor VIII with appropriate modifiers and revenue codes (0250, 0490, 0636). For FQHC/RHC providers, switch to per-claim PPS billing method instead of individual practitioner fee-for-service billing.

Affected Billing Codes

Q9975