knowledge/lexical/codes
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| node_id UInt32 | code Utf8 | text Utf8 | __row_id Int64 |
|---|---|---|---|
| 5081 Filter to this value Explore graph node | 212.200 Filter to this value | 212.200 payable-with-criteria: These services will be available until the termination of the federal public health emergency, including any extensions, or December 21, 2022, whichever occurs first. | 330 |
| 5083 Filter to this value Explore graph node | 213.000 Filter to this value | 213.000 effective date: January 1, 2021 payable-with-criteria: The rate reduction scheduled to occur January 1, 2021 will be suspended until the termination of the federal public health emergency, including any extensions, or until the Centers for Medicaid & Medicare Services (CMS) approves the implementation of the rate in Arkansas' Living Choices Waiver Renewal, whichever occurs first. | 331 |
| 5098 Filter to this value Explore graph node | 194 Filter to this value | 194 criteria: Attach a cover sheet requesting coverage of Swing Bed in a critical access hospital. criteria: Bill all dates of service for each month on one claim (there will be separate claims filed for dates of service in different months) criteria: Bill at the amount of $400 per day. criteria: Claims can be submitted electronically or by paper with required attachments criteria: Provider Type 05 - Hospital/Provider Specialty CH - Critical Access Hospital criteria: Revenue Code 194 should be billed for Swing Bed days. criteria: at a rate of $400 per diem criteria: for the following providers: • Provider Type 05 - Hospital/Provider Specialty CH - Critical Access Hospital disposition: payable-with-criteria effective date: through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first effective date: through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first. | 332 |
| 5104 Filter to this value Explore graph node | Q0239 Filter to this value | Q0239 effective date: November 9, 2020 medicaid-ar code-disposition effective date: November 9, 2020 medicaid-ar code-disposition payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs | 333 |
| 5107 Filter to this value Explore graph node | M0239 Filter to this value | M0239 effective date: November 9, 2020 medicaid-ar code-disposition effective date: November 9, 2020 medicaid-ar code-disposition payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs | 334 |
| 5110 Filter to this value Explore graph node | Q0243 Filter to this value | Q0243 effective date: November 21, 2020 medicaid-ar code-disposition effective date: November 21, 2020 medicaid-ar code-disposition payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs medicaid-nv code-disposition effective-date: 1/24/2022 payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs | 335 |
| 5113 Filter to this value Explore graph node | M0243 Filter to this value | M0243 effective date: November 21, 2020 medicaid-ar code-disposition effective date: November 21, 2020 medicaid-ar code-disposition payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs payable-with-criteria: The patient must have a COVID-19 diagnosis and be considered at high risk for progressing to severe COVID-19 and/or hospitalization. The Arkansas Department of Health (ADH) issued an updated Health Alert through the Health Alert Network (HAN) on November 25, 2020, that outlines the criteria and limitations on use of these monoclonal antibodies. DMS will follow the criteria and limitations outlined in that ADH alert and by the FDA in their Emergency Use Authorizations (EUAs) for the above listed drugs | 336 |
| 5117 Filter to this value Explore graph node | 87426 Filter to this value | 87426 criteria: Section 225.100(A), regarding limitations on outpatient laboratory services, is suspended as to claims for COVID-19 antigen laboratory testing using procedure code 87426 through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first. criteria: claims for COVID-19 antigen laboratory testing using procedure code 87426 through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first. medicaid-ar code-disposition criteria: Section 225.100(A), regarding limitations on outpatient laboratory services, is suspended as to claims for COVID-19 antigen laboratory testing using procedure code 87426 through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first. medicaid-ar code-disposition criteria: claims for COVID-19 antigen laboratory testing using procedure code 87426 through the termination of the federal public health emergency, including any extensions, or December 31, 2022, whichever occurs first. | 337 |
| 5124 Filter to this value Explore graph node | 99499 Filter to this value | 99499 criteria: Allowed two times in a 12-month period, per provider. criteria: Billable with any ZOO diagnosis code criteria: HCA will pay for one encounter, per client, per day unless the periodic evaluation is performed by a provider of a different specialty or there is an unrelated diagnosis. criteria: The medicaid agency pays for one encounter, per client, per day, except in the following circumstances: (a) The visits occur with different health care professionals with different specialties; or (b) There are separate visits with unrelated diagnoses. criteria: When CPT® codes 99429 and 99499 are billed to the client's MCO, the codes must be billed according to existing FQHC and RHC policy regarding two encounters in one day. disposition: payable-with-criteria effective date: not-stated medicaid-ar code-disposition payable-with-criteria: This code is not to be used in conjunction with any other E&M or encounter code that may be billed by the provider but only be used to reflect a screening for COVID-19 (i.e., completing a questionnaire and taking temperature). medicaid-ar code-disposition payable: The rate is $25.00 for each screening. medicaid-ar furnishing-rule who may perform: APRNS (PT 58) medicaid-ar furnishing-rule who may perform: Federally Qualified Health Centers (PT 49) medicaid-ar furnishing-rule who may perform: Hospitals (PT 05) medicaid-ar furnishing-rule who may perform: Physicians (PT 01 & 03) medicaid-ar furnishing-rule who may perform: Rural Health Clinics (PT 29) medicaid-wa code-disposition criteria: (1) The medicaid agency pays for one encounter, per client, per day, except in the following circumstances: (a) The visits occur with different health care professionals with different specialties; or (b) There are separate visits with unrelated diagnoses. medicaid-wa code-disposition criteria: HCA will pay for one encounter, per client, per day unless the oral screening is performed by a provider of a different specialty or there is an unrelated diagnosis. medicaid-wa code-disposition criteria: HCA will pay for one encounter, per client, per day unless the periodic evaluation is performed by a provider of a different specialty or there is an unrelated diagnosis. medicaid-wa code-disposition criteria: Oral screening allowed two times in a 12-month period, per provider. medicaid-wa code-disposition criteria: The medicaid agency pays for one encounter, per client, per day, except in the following circumstances: (a) The visits occur with different health care professionals with different specialties; or (b) There are separate visits with unrelated diagnoses. medicaid-wa code-disposition criteria: When CPT® codes 99429 and 99499 are billed to the client's MCO, the codes must be billed according to existing FQHC and RHC policy regarding two encounters in one day. medicaid-wa code-disposition criteria: allowed two times in a 12-month period, per provider medicaid-wa code-disposition criteria: one encounter, per client, per day unless the oral screening is performed by a provider of a different specialty or there is an unrelated diagnosis medicaid-wa code-disposition criteria: twice in a 12-month period. medicaid-wa code-disposition criteria: with any Z00 diagnosis code medicaid-wa code-disposition disposition: payable-with-criteria payable-with-criteria: Billable DA with any Z00 diagnosis code payable-with-criteria: HCA will pay for one encounter, per client, per day unless the oral screening is performed by a provider of a different specialty or there is an unrelated diagnosis. payable-with-criteria: Oral screening allowed two times in a 12-month period, per provider. payable-with-criteria: The medicaid agency pays for one encounter, per client, per day, except in the following circumstances: (a) The visits occur with different health care professionals with different specialties; or (b) There are separate visits with unrelated diagnoses. payable-with-criteria: This code is not to be used in conjunction with any other E&M or encounter code that may be billed by the provider but only be used to reflect a screening for COVID-19 (i.e., completing a questionnaire and taking temperature). payable-with-criteria: twice in a 12-month period. payable: The rate is $25.00 for each screening. who may perform: APRNS (PT 58) who may perform: Federally Qualified Health Centers (PT 49) who may perform: Hospitals (PT 05) who may perform: Physicians (PT 01 & 03) who may perform: Rural Health Clinics (PT 29) | 338 |
| 5135 Filter to this value Explore graph node | U0001 Filter to this value | U0001
disposition: payable-with-criteria
medicaid-ar code-disposition
disposition: payable-with-criteria Filter to this value | 339 |