First Coast Advantage (FCA) was notified on January 19, 2010 by the Agency for Healthcare Administration (AHCA), that some of our providers are submitting Child Health Check Up (CHCUP) office visit code and the sick office/outpatient visit code on the same date of service and are getting reimbursed. It is against Medicaid policy to submit both office visit types on a claim for the same recipient on the same date of service. 

AHCA is advising FCA to instruct providers that have submitted these types of claims to void and resubmit the claims using only the CHCUP office visit code or the sick office/outpatient visit code. Currently, there are no edits in the EDS system to prevent the claims from paying when this occurs (It has been requested by AHCA to have EDS implement this change, but it has not occurred).