substance abuse

  1. M

    Wiki Place of Service questions

    Hello! I am a somewhat new biller and got my experience solely from the office I currently work at and through AAPC billing course. I work for an Outpatient Drug and Alcohol treatment center, we also provide co-curring mental health/substance use services. The POS, Place of Service is always a...
  2. M

    Wiki Therapy Billing

    I recently started billing and coding for a Therapist/Counselor for substance abuse. I am billing all insurance as out of network. My claims are continuously getting denied. How should I be billing out of network for a substance abuse therapist?
  3. R

    Wiki Help with Coding Substance Abuse ICD-10 CM

    Hello All, I am a coder in training, and I have been having a hard time wrapping my head around the F-codes. I am struggling a lot with F10-F19, specifically when to use F1_.10 (___ abuse/dependence/use, "uncomplicated") vs F1_._88 (___ abuse/dependence/use with other ___-induced disorder). My...
  4. R

    Wiki Adolescent Residential billing for MH and SUD

    I need help. I have been billing for adults my whole career, but now have some questions regrading adolescents. This would be for residential care at a residential facility. Primary dx will usually be MH, and I cannot find any specific information on if billing will even change from what I am...
  5. R

    Wiki Substance TX and Private Insurance Billing

    I bill for a group practice that is fairly new to private insurance. Our main payer is state medicaid. I am having a hard time trying to get info on how to bill private insurances when services are rendered under a certified addiction counselor...the state of Maryland acknowledges CAC's but most...
  6. J

    Wiki Clinical Documentation Requirements

    Hello, Billing for Arizona Medicaid for Substance Use IOP. I understand updating treatment planning, but in doing the treatment planning, would your counselors do an assessment or an individual therapy session to update it? My other thoughts lean to IOP being per diem. If they do IOP class and...
  7. J

    Wiki Behavioral health coding- help!

    Hello coding world, I am a brand new coder and took a position as the only coder/biller at a small counselors office. So, I don't have anyone above me to help with my questions. The question is regarding Arizona Medicaid and the correct code for services. The HCPCS code for a drug and/or...
  8. M

    Wiki Anthem Denials for Substance Abuse

    Beginning March 1, 2018 our California facility began receiving denials for our institutional claims and are now requesting medical records. We are aware that the codes do change twice a year but this is more than that. We are looking for advice from fellow substance abuse billers. Has anyone...
  9. J

    Wiki Group- Substance/Alcohol Abuse

    I am in Arizona and bill for a counselors office. I am wondering which code to use for a group therapy that is for substance and/or alcohol abuse. It is an intensive outpatient therapy but not all of the patients attending the group sessions meet the HCPCS requirement for the group (H0015; which...
  10. S

    Wiki Advice on best book to have on hand for Behavioral Health coding & Billing

    Just started Billing & Coding for a Behavioral Health Center and wanted to see if anyone had suggestions on the best book & or tools to have on hand. I looked through AAPC, but wanted any and all opinions. Thank you for any and all help!!!
  11. T

    Wiki Billing Assessments at Facility

    Hi, I currently work for a company that provides all LOC's including RESIDENTIAL, PARTIAL HOSPITALIZATION (PHP) and INTENSIVE OUTPATIENT (IOP-Facility). We do NOT have a traditional outpatient program here so only facility services are provided. I would like to know if there is a way to bill...
  12. C

    Wiki H0006 another code

    BC is now denying case management code H0006 stating H and T codes are to be billed by Medicaid, any suggestions on a replacement code? Thanks
  13. T

    Wiki Billing for alcohol/substance abuse INITIAL ASSESSMENTS

    Hi CodingKing, I started working in behaviroal health about six months ago so I don't have much experience with the specialty. Currently working in the residential center providing RES/PHP/IOP services. My question is in regards to my outpatient clinic coding. Typically for a patient that is...
  14. M

    Wiki New to Billing- need someone to consult with PLEASE

    Hi there, I am recently certified CPC-A as of 12/12/15 but have been working for the same substance abuse treatment center for 4 years. We recently brought in billing to be done in house (myself and my coworker). We bill for Detox, RES, PHP, IOP, OP. We also are beginning to do psychiatric...
  15. T

    Wiki Cigna denying F1220 as admitting dx code

    I work at an inpatient facility for substance abuse and my claims for residential level of care are making it through my clearinghouse, but being blocked by the payer CIGNA stating that the "admitting diagnosis code: invalid for payer." The code DSM 5 Description for F1220 is for Cannabis use...