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Substance abuse IOP-PLEASE HELP!

  1. #11
    Exam Training Packages
    Quote Originally Posted by abalkevitch View Post
    I work at an IP/OP psych facility, and we do Intensive Outpatient Substance Abuse programs. We have been billing this for Medicare on a UB with rev code 906 and HCPCS
    H0015, but they are all being rejected for incorrect HCPCS code. Is there a different HCPCS we should be using? I tried using rev code 905, I tried using HCPCS S9480, and none of them will go through. The H0015 is also being rejected by another insurance company that is telling me that H0015 is considered a "temporary code" and I need to use the "permanent code". I have never even heard of a temporary code. I am new to coding and this is my first job, but I am only the biller, and our facility doesn't really have a coder. My boss is frustrated because we have not been able to figure this out and no one has been able to help us. I am hoping someone here can help us to figure this out!!
    I know in some instances where Medicare doesn't cover a service, that service can be billed to the secondary insurance using a GY modifier, then it may be covered? Would this work for you? We don't do inpatient here, but we have used GY for our OP clients (we bill on HCFA's). Might ask? If the client has a secondary insurance that is....

  2. #12
    Tucson Cactus Coders
    Default H0015
    I work in behavioral health for Medicaid and you are correct in saying that Medicare will not cover these codes/services.

    They are covered by Medicaid (AHCCCS) in Arizona, and can be billed for denial and then sent to the 2ndary.

    Hope this helps.


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