What is it?
Box 24h is used to identify services that may be covered under specific state plans.
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.
The following codes for EPSDT can be used:
- 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.
To manually change this information:
- Navigate to Billing > Bill Insurance.
- Use Select Client to choose the desired client.
- Locate the session and select the corresponding icon.
- Under Billing & Coding, enter the code into the EPSDT field.
- Select Save & Done.
Loop 2400, Segment SV111