VA Family Medical - CHAMPVA 2.0.1

The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) serves as a crucial health care resource for spouses and children of disabled Veterans, as well as surviving spouses and children of deceased Veterans who do not qualify for TRICARE.

The CHAMPVA mobile application is a tool that supports both medical service providers (from the VA and private practice) and beneficiaries in managing care and medical procedures. This app allows users to engage individually or collaboratively during patient interactions, facilitating the determination of VA coverage for specific medical services.

To identify covered services and equipment, the CHAMPVA app incorporates various medical code sets, featuring more than 270,000 individual codes organized into several categories:

• Current Procedural Terminology (CPT) Codes: These codes categorize medical, surgical, and diagnostic services, aiding in the identification of services rendered.
• ICD-10 Codes: This code set corresponds to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, encompassing a range of data related to diseases, symptoms, and external causes of injury or illness. The app utilizes ICD-10-CM data sourced from the Centers for Medicare and Medicaid Services (CMS).
• Healthcare Common Procedure Coding System (HCPCS) Codes: HCPCS provides standardized codes to describe healthcare items and services. This coding system is essential for processing claims across CHAMPVA, Medicare, Medicaid, and other insurance programs in a consistent manner.
• Durable Medical Equipment (DME) Codes: These codes refer to equipment that is intended for prolonged use in a medical context and is essential for home care. DME codes are included within the HCPCS structure.
• National Drug Codes (NDC): These unique 10-digit codes serve to identify drugs intended for human use. The NDC is segmented into three parts: a labeler code assigned by the FDA, a product code identifying drug specifics, and a package code detailing packaging information.

The application also provides billing information by using an 11-digit format derived from NDC codes. Subsequently, it sources data published by the FDA to translate NDC codes into billing codes. Users can search medical codes via various identifiers such as alphanumeric codes or descriptions.

Upon finding a relevant medical code, users can check its coverage status by CHAMPVA; however, it's important to note that results do not imply authorization for purchases by the Department of Veterans Affairs.

The app includes a comprehensive CHAMPVA program guide that elaborates on benefits, offering links to pertinent websites and providing clickable phone numbers for immediate assistance. This guide enhances accessibility through a searchable table of contents and index, with an accompanying Portable Document Format (PDF) version available for convenience.

Furthermore, the CHAMPVA app features a facility locator function that enables users to search by facility type, helping them find nearby providers among over 2,400 VA facilities nationwide. It also facilitates the search for providers and pharmacies participating in the VA Community Care Program to ensure beneficiaries receive optimal care.