Wiki inpatient substance abuse treatment

[RCHANDLER]

Hi, i bill for a hospital in NY that does inpatient substance abuse treatment ( detox and rehab), they also do medication maintenance once patient is discharged, and pain management for patients who have to use opiates to treat medical conditions. I have been searching for days on the correct way to bill these encounters. as in correct cpt codes, pos when admitted and during outpatient visits. For all inpatient we are using cpt codes 99221-9922 and 99231-99233 with pos 21 for all admitted detox and rehab patients. Then for the medication management we use 99201-99205 or 99211-99215 with pos 23? can anyone tell me where to find help at.

 

[Cavalier40]

Are you referring to just the physician fees, or also the facility charges?

For the physician fees if the patient is inpatient at a hospital (as long as its not a free standing rehab facility) You should be able to use the inpatient e/m set 99221-99223 for the initial encounter and 99231-99233 for subsequent encounters with POS 21. As for the outpatient visits, I would use POS 22 not 23 unless the visits are in a separate office setting in which you can use POS 11.

Facility charges are a whole other ball of wax.

Hope this helps.

 

[RCHANDLER]

Substance abuse treatment

Thank you. I was talking about only the physician charges. And I meant 22 not 23. I just can’t beli that with as bad as the drug problem is and having so many treatment centers and things that there isn’t anything out there to help guide on how to do this properly.

 

[Cavalier40]

I have been doing billing and coding for MH/SA for 5 years after moving from DME, its still a wild west out there. The physicians fees are perhaps the easiest part as they mirror the inpatient hospital codes and only the POS changes depending on if the facility is a hospital for free standing treatment facility. However the rest of this scope of practice is a mess, there are several ways to code the same service depending on the insurance. I could write a basic guide on how it should be coded, but it will probably change again before I am finished writing it.