Medicare Compliance & Reimbursement - 2019 Issue 10
You Be the Coder: Get the Skinny on Substance Screening
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Article Overview
This premium article reviews how to think about billing a screening-and-intervention encounter when substance use is documented in the emergency department. It is aimed at coders and billing staff who need to compare CPT and Medicare reporting options, understand the time-based structure of the service, and recognize related preventive assessment codes that should not be reported together.
Why This Topic Matters
Choosing the wrong code family can lead to incorrect reporting for behavioral health screening services and related brief interventions. The article helps readers identify the relevant code sets and avoid conflating substance screening with tobacco cessation counseling or with patient-focused health risk assessments.
What You Will Learn
- Which code families are associated with alcohol and substance abuse screening and brief intervention services
- How Medicare reporting alternatives relate to the CPT service family
- What general documentation elements are associated with time-based screening and intervention services
- Which broadly related assessment codes are addressed as not separately reportable in this context
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Emergency department coding staff
Codes Discussed
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