crystalgriswold
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I bill for a facility that provides suboxone treatment for patients with opiate addiction and we are continuously running into an issue getting our claims paid under the patients medical plan due to the diagnosis on the claim even though we are using a medical CPT code and biling under a Medical Provider. However, we cannot bill to the behavioral plan under a Medical Provider and the behavioral plan will also not cover the urine screen or LFTs if we have a mental health provider see the patient which is another reason why we're having MD's see them. Due to DEA regulations we are limited to how many patients a physician can supervise therefore requires medical physicians to be involved as well. Is anyone else having this issue and what have you done to resolve it? I have found that some insurances are allowing the claims billed with diagnosis V58.69 (long term use of current medications) however we're still not sure if this is coding to the highest level of specificity so we're trying not to utilize that DX if possible. PLEASE HELP!!