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:

The Behavioral Health Services Matrix (formerly called B2 Matrix) is undergoing an update

Behavioral Health Services Matrix questions, changes and updates must be submitted via the Reference Table Review and Update (RTRU) Form.

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 (updated 01/24/2024)

OPFS Related Extracts

Telehealth Code Set (updated 06/16/2023)

Pay and Chase EPSDT Diagnosis Extract

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

OPFS Allowed Modifiers Extract (updated 01/24/2024)

FFS Prior Authorization Guidelines (updated 01/24/2024)

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 our policies and other pertinent information.

FAQs




Contact Information

Email: CodingPolicyQuestions@azahcccs.gov