Not Used used when no EPSDT patient referral was

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					Messages for Remittance Advices dated – January 26, 2012 – February 2, 2012
TO: ALL PROVIDERS                                                                     RE: AEVCS DOWNTIME
AEVCS will not be accessible during scheduled maintenance beginning at 12:01 a.m. on Sunday, 02/19/2012 and ending by 9:00 a.m. on Sunday, 02/19/2012. All
electronic transactions, including Pharmacy, Eligibility, and Claims, will be unavailable during this downtime. We apologize for any inconvenience.

TO: CHILD HEALTH SERVICES (EPSDT), CERTIFIED NURSE-MIDWIFE,                           RE: COMPLETE THE EPSDT REFERRAL FIELDS FOR EPSDT CLAIMS
DENTAL, HEARING, LICENSED MENTAL HEALTH PRACTITIONER, NURSE
PRACTITIONER, PHYSICIAN, VISUAL CARE
Providers submitting claims for EPSDT screenings/services on PES 2.15 or through the Medicaid Web site (DDE) must complete the EPSDT Referral fields. Failure
to complete these fields will result in your claims being denied.
On PES, if the EPSDT screening/service resulted in a referral or prescription for additional services, select Yes in the Certification Condition Indicator and on DDE,
check the Box and then the appropriate Condition Indicator: AV = Available – not Used (patient refused referral); NU = Not Used (used when no EPSDT patient
referral was given); S2 = Under Treatment (patient is currently under treatment for referred diagnostic or corrective health problem); ST = New Service Requested
(referral to another provider for diagnostic or corrective treatment/scheduled for another appointment with screening provider for diagnostic or corrective treatment for
at least one health problem identified during an initial or periodic screening service, not including dental referrals.)
These codes are required when billing for EPSDT screenings/services. The code should indicate actions taken as a result of the screening.
On both PES and DDE, if No is selected, you need to select NU as the appropriate Condition Code.
NOTE: On both DDE and PES, the Special Program Code 01 (EPSDT) will still need to be selected for these services
If you have questions, please contact the HP Provider Assistance Center at 1-800-457-4454 (toll-free) within Arkansas or locally and out-of-state at (501) 376-2211.

If you need this material in an alternative format, such as large print, please contact our Americans with Disabilities Act Coordinator at 501-682-0593 (Local);
1-800-482-5850, extension 2-0593 (Toll-Free) or to obtain access to these numbers through voice relay, 1-800-877-8973 (TTY Hearing Impaired).
Thank you for your participation in the Arkansas Medicaid Program. If you have questions regarding these messages, please contact the HP Provider
Assistance Center at 1-800-457-4454 (toll-free) within Arkansas or locally and out-of-state at (501) 376-2211.
Remittance Advices cannot be forwarded. Notify the Arkansas Medicaid Program of any address change, indicating all provider numbers affected by
the change. This notification must include the provider’s original signature (no facsimiles accepted).

				
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posted:4/21/2012
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