If the EPSDT check box is selected in the Insurance Carrier Table AND the procedure code entered is 99381, 99382, 99383, 99384, 99385, 99391, 99392, 99393, 99394, or 99395 AND/OR any code with the EP modifier, it will trigger the EPSDT Attachment.
Data Field Information
| Prompt | Response | Req | Len |
|---|---|---|---|
| EPSDT Referral Given | If an EPSDT referral was given, select this check box. | 
|
1 |
| Condition 1 | Select the condition from the list. | 1 | |
| Condition 2 | Select the condition from the list. | 1 | |
| Condition 3 | Select the condition from the list. | 1 |
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