EPSDT Indicator

Rejection Details:

This rejection occurs when the 2300 Loop is missing the CRC segment (EPSDT indicator). The EPSDT (Early Periodic Screening, Diagnosis, and Treatment) referral information was expected but not found.

Resolution:

Follow the instructions below to add an EPSDT Indicator and fix this rejection:

• Go to Patient> Billing> Charges
• Click on the appointment date for which the indicator is requird.
• Click on the “+” icon next to CTP to expand line level options.
• Check the box for “EPSDT Service” to populate the CRC segment.
• Select “EPSDT Ref. Code” to populate “Y”/”N” (Yes/No) in the EDI file.
• Selecting “NU” = No – Selecting AV/S2/ST = Yes
• Save the charge and resubmit the claim

Note: This only applies for Medicaid plans or any plan with MC claim filing indicator.