What it is:
Box 24h is used to identify certain services that may be covered under some state plans. For Early & Periodic Screening, Diagnosis, and Treatment-related services enter the response in the shaded portion of the field as follows:
If there is no specific requirement, you can enter a Y for yes or an N for no in the EPDST box. However, please check your Insurance's Billing Guidelines for the specifics on what is required as insurances may need this field to reflect information.
If there is a requirement to use a specific reason code, then you would enter that code in the EPDST field on the session instead of entering a Y or N. This code lets the insurance know the referral status and may be specific to each payer. Below are examples of codes that may be used, however, please be sure to verify with your Insurances if there are specific Box 24H reason codes they require.
The following codes for EPSDT are used in 5010A1:
AV Available – Not Used (Patient refused referral.)
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.)
NU Not Used (Used when no EPSDT patient referral was given.)
If the service is Family Planning, enter Y (“YES”) or N (“NO”) in the bottom, unshaded area of the field.
Therabill will use the EPSDT from the Billing & Coding section of the Edit Session dialog to populate box 24h.
From the dashboard click on the green New Session button. You will be on the Entering New Session page. Enter the correct two letter code in the EPSDT field for the services that will be/were performed.