BH Diagnosis

espforu

Guru
Local Chapter Officer
Messages
140
Location
NAPLES, FL
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I am new to this specialty on top of having to handle how Medicaid prefers to use H codes(I think I have this under control) :)

But, we are trying to get a handle on the diagnosis codes as to which codes they are covering. Can anyone give me some insight as Medicaid is very vague and does not precert services. Based on what I have seen they are a covering services for codes in the Mental and Behavioral Disorders category(F codes) but the provider used R46.2 Strange and inexplicable behavior as a sign and symptom.

Does anyone have a guidance or reference you can refer me to? or advice?

Thanks,

:confused:
 

sarowe

New
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8
Location
Chesapeake
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Hi!

I'm not sure which Medicaid you're billing, however in my experience if you go to their website, there are lists of covered diagnoses. Additionally, for the three Medicaids that I bill, there are behavioral health contractors, meaning that I don't bill traditional Medicaid for my provider's services. If you are not able to locate a list on their website, you could always call and talk to a Medicaid rep and see if they can help point you in the right direction.

If all else fails, you could query the physician to see if they can provide a more definitive usable diagnosis.

Hope this helps and good luck!

:)
 
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