Medical Coding Resources


Medical Coding Resources are intended for use by AHCCCS MCO's and Providers.

The AHCCCS Medical Coding Unit is responsible for the update and maintenance of all medical coding related to AHCCCS claims and encounters processing. This includes place of service, modifiers, new procedure codes, new diagnoses, and coding rules. This unit is also responsible for reviewing and responding to any medical coding related guidelines or questions. This includes questions related to daily limits, procedure coverage, etc.

The AHCCCS Medical Coding Unit utilizes a process referred to as a Reference Table Review and Update (RTRU) and its related form to track all and respond to all medical coding related questions and requests for updates from both internal as well as external parties. All requests for updates need to be submitted on an RTRU form. The form and instructions on how to fill out the form can be found here:

AHCCCS Behavioral Health Services Guide FAQ

  • FAQ (posted 10/15/2024)

The AHCCCS Behavioral Health Services Matrix (B2 Matrix) is updated and published monthly, with the current month's information. Refer to the 'as of' date in the header of the Matrix document below:

The AHCCCS Covered Behavioral Health Services Guide (CBHSG) is updated and published as needed. Refer to the CBHSG below:

The AHCCCS Same Day Disallow Table includes the most commonly used per diem, single day, counseling, treatment, and assessment/screening/evaluation code combinations. This is not an exhaustive list of all available codes. Refer to the AHCCCS Same Day Disallow Table below:

AHCCCS will be developing and rolling out various Reference Extracts and will place the completed information here upon completion.

Crisis, COE, COT, MABG and SABG Billing Indicators/Modifiers

HCPCS – CPT Procedures Daily Limits Guidelines (posted 12/10/2024)

OPFS Related Extracts

Telehealth Code Set (posted 12/18/2024)

Pay and Chase EPSDT Diagnosis Extract

Multiple Surgery Codes Extract (added 03/10/2023)

OPFS Allowed Modifiers Extract (updated 08/07/2024)

FFS Prior Authorization Guidelines (posted 10/02/2024)

The AHCCCS Medical Coding Unit has created a list with most frequently asked questions and answers to help assist you with your question. This does include links to AHCCCS policies and other pertinent information. Refer to the FAQs below:

FAQs




Contact Information

Email: CodingPolicyQuestions@azahcccs.gov