decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Appendix E - National Coverage Determinations Manual / TREATMENT_OF_DRUG_ABUSE
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Article Overview
This page explains a Medicare coverage policy on treatment of drug abuse, including when inpatient hospital care or outpatient hospital department services may be covered. It is intended for coding, billing, and compliance professionals who need to understand the policy’s scope, the medical-necessity framework, and the related Medicare manual references that support claims review.
Why This Topic Matters
Understanding this coverage policy helps providers and revenue cycle staff assess whether treatment settings and related services may fall within Medicare coverage requirements for drug abuse care.
Article Sections
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Treatment of Drug Abuse (Chemical Dependency) 130.6
Overview of the Medicare coverage policy for treatment of drug abuse and related setting-based considerations. The section discusses how the policy is framed within the National Coverage Determinations Manual and related Medicare guidance.
What You Will Learn
- The general Medicare coverage framework for treatment of drug abuse
- How inpatient and outpatient hospital settings are addressed in the policy
- Which Medicare manual references are associated with this coverage topic
- How medical necessity and level-of-care considerations are addressed at a policy level
Who Should Read This
- Medical coders
- Billers
- Compliance staff
- Revenue cycle professionals
- Hospital outpatient department staff
- Utilization review personnel
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