Wiki Substance abuse coding

nanbr340

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I have started a new career in the Substance abuse field and have a ton of questions regarding professional vs revenue codes. Anyone out there in experienced in this field or can dirrect me to somewhere to find classes or a mentor?
 
billing revenue code 0906 for IOP level but some patients are not coming 9 hours a week.
It is my understanding that this code is for 9 to 14 hours.
Also for code 1002 and 0912 when I am asked for notes from the insurance some days we do not have 1:1 sessions for every patient noted and they were in groups. How to you address this with the insurance?
 
IOP codes-listed in HCPCS manual -check H and S codes

Hello
Revenue codes are department codes for treatment in the inpatient setting. You need to check the psych procedure you did and it should be coded CPT or 5 digit code into the HCPCS manual. Both of the revenue codes and HCPCS codes are listed on the UB04 form the hospital billing. However your question of IOP-intensive outpatient procedures can be billed for 3 hours a day use codes .These HCPCS manual codes of H0015 (MH) or S9480 (sub abuse) linked with revenue codes of 905/906 define intensive outpt. Partial hospital psych codes are listed with CPT 99221 to 992333.

I hope I helped you
 
You can do group with IOP services

Hello Again;)
You can do a variety of treatments with IOP in the inpatient setting. Group, individual therapy, etc. and use S or H codes found in HCPCS manual . But always check with the insurance payers for their billing guide to be exact cause the companies to vary with regulations.

Have a good day!:)
 
Sud

We specialize in substance abuse coding... what are your questions?

what HCPCS codes do you for initial visit and therapy and treatment plan for someone with bachelor science

what HCPCS codes do you for initial visit and therapy and treatment plan for someone with Masters

what HCPCS codes do you for initial visit and therapy and treatment plan for someone with MD/DO
 
Still confused

So if a facility is strictly out patient and only offers therapy H0015, the a CMS1500 form should be used and not a UB04?
The CMS guidelines read as though I should only be using a UB04 if they have an overnight stay with us. Is this accurate?
 
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