Box 24h - EPSDT/Family Plan

Box Definition

Box 24h is used to identify services that may be covered under specific state plans. EPDST stands for "Early and Periodic Screening, Diagnosis, and Treatment."

Enter a response in the shaded portion of the field for EPDST.

If there is no requirement to report a reason code for EPDST, enter Y ("YES") or N ("NO").

If there is a requirement to use a specific reason code, then enter the appropriate reason code. 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.

In AveaOffice

This field is not editable in AveaOffice.

EDI Loop/Segment

Loop 2400, Segment SV111