Is this for Missouri Medicaid? (Each state's Medicaid program has it's own billing guidelines and those can vary widely from state to state.)
I took a quick glance at the Missouri Medicaid provider manual for Behavioral Health Services, under the assumption that we're talking about Missouri Medicaid. Before disputing with a payer, it can be helpful to narrow down why the claim denied and if there was something that could have been billed differently instead vs needing to be appealed.
What is the denial reason or remark codes being given?
Is this for adult or child services? It looks like for adults there's a precertification limit of 10 hours per rolling year for Z-code diagnoses. (p 29 of the manual). If these are adult patients, is it possible they've exceeded the 10 hour limit per rolling year?
Was precertification obtained? If so, does the billed diagnosis match the precert diagnosis?
Those are just a few questions off the top of my head after looking at the MO Medicaid manual. I'd be especially curious to hear the remark codes being given on the denials.