Behavioral Health|Drug Rehab Articles and Resources
News and Important InformationNew Biofeedback Codes to Replace 90911, Eff 2020-01-01 The ICD-10 Classification of Mental and Behavioural Disorders Intensive Outpatient Treatment (IOP) Psychiatric Partial Hospitalization Programs Code SetsPsychiatry CPT CodesCPT Codes for Psychiatry, Psychotherapy, etc. ICD-10-CM CodesICD-10-CM codes for Mental, Behavioral and Neurodevelopmental disorders. Health and Behavior Assessment CPT CodesHealth and Behavior Assessment/Intervention Procedures Central Nervous System CPT CodesCentral Nervous System Assessments/Tests Find-A-Code's Tools & ResourcesClick-A-Dex™Click-A-Dex™ Index Search Tool Build-A-CodeBuild your code step by step NCCI Edits ValidatorValidate using NCCI edits for errors in code selection. Pro-Fee CalculatorVerify Medicare Reimbursement and UCR Fees for Professional Services Additional Links and ResourcesNoridian: Mental Health ResourcesNoridian JE Part B Mental Health Resources Mental Health Services BookletCMS Mental Health Services Booklet Drugs and Biologicals Pub-100 Ch 17Drugs and Biologicals Pub-100 Ch 17 CMS Substance AbuseMedicare Coverage of Substance Abuse Services Billing Requirements for OPPSBilling Requirements for OPPS Providers with Multiple Service Locations Select the title to see a summary and a link to the full article. August 16th, 2019 Medical ID Theft| Published August 16th, 2019 - Last Review/Update August 20th, 2019 Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ... August 9th, 2019 The OIG Work Plan: What Is It and Why Should I Care?| Published August 9th, 2019 - Last Review/Update August 14th, 2019 The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ... July 12th, 2019 5 Ways to Minimize HIPAA Liabilities| Published July 12th, 2019 - Last Review/Update July 30th, 2019 Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability.
Take ... April 24th, 2019 Biofeedback - Is it Medically Necessary?| Published April 24th, 2019 Biofeedback is used for many reasons, and most commonly used for pain management. Each payer should be consulted with to verify coverage when treating with Biofeedback to verify if the treatment is considered experimental or investigational.
The majority of payers will list Biofeedback on an exclusions list. Others such as BC ... February 5th, 2019 Clinical Staff vs. Healthcare Professional| Published February 5th, 2019 State scope of practice laws and regulations will help determine who is considered Clinical staff and Other qualified Health Care professionals.
Physician or other qualified healthcare professionals: Must have a State license, education training showing qualifications as well as facility privileges.
Examples of Qualified Healthcare professionals:
(NOTE: this list is not all-inclusive, please refer to your payer ... October 17th, 2018 Wolters Kluwer Drug Pricing| Published October 17th, 2018 Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average... August 31st, 2018 Finalized Confidentiality of Alcohol and Drug Abuse Patient Records Regulations| Published August 31st, 2018 In January, the U.S. Department of Health and Human Services (HHS) issued updates to the privacy regulations regarding the confidentiality of patient information of substance use disorder patients (42 CFR Part 2). This notice included references to better alignment with HIPAA regulations, but did state that Part 2 is more protective ... May 9th, 2018 Preventive Medicine: Counseling to Prevent Tobacco Use| Published May 9th, 2018 - Last Review/Update August 1st, 2018 Preventive Medicine Topics Page
Counseling to Prevent Tobacco Use
Procedure Codes 99406: Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes 99407: Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
ICD-10-CM 99406-99407: No specific diagnoses
Frequency 99406-99407: 2 attempts a year, ... May 9th, 2018 Preventive Medicine: Depression Screening| Published May 9th, 2018 - Last Review/Update August 1st, 2018 Preventive Medicine Topics Page
Depression Screening
Procedure Codes G0444: Annual depression screening, 15 minutes 96127: Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument
ICD-10-CM G0444, 96127: No specific diagnoses
Frequency G0444:Once annually 96127: No specific frequency guidelines
Additional Information 96127
Only covered for ages ... February 13th, 2018 Payment Rates Increase for Behavioral Health Office Services| Published February 13th, 2018 Behavioral health providers may see some improvement in payment rates for office-based behavioral health services. This is due to the fact that the overhead expense evaluation portion of the RVU was increased. The following information is from the Federal Register (see References):
We agree with these stakeholders that the site of service ... January 29th, 2018 Dental and Medical- Controlled Substance Awareness| Published January 29th, 2018 As an effort to cut down on opioid abuse and related crimes, in August of 2017 the Attorney General Sessions established a new Department of Justice (DOJ) section called “Opioid Fraud and Abuse Detection Unit”. Due to the serious public health issue and drug overdose deaths, this unit was established and ... January 25th, 2018 Psychiatric Partial Hospitalization Programs| Published January 25th, 2018 Psychiatric Partial Hospitalization Programs (PHPs) are a more comprehensive level of care than Intensive Outpatient Programs (IOPs - click here to read more about IOPs). When the patient requires a minimum of 20 hours per week and hospitalization is not clinically indicated, a PHP can be the most effective type of ... January 18th, 2018 Medicare's Integrated Behavioral Healthcare Services and Collaborative Care Program| Published January 18th, 2018 Over the last several years, primary care has begun to integrate behavioral health services to better address shortfalls in patient quality of care. Some of the first codes were the Health and Behavior Assessment/Intervention (96152-96155) codes, which were added in 2002. Since then, many different models have been experimented with and have ... January 15th, 2018 Medicare Requiring Specific Modifiers on Therapy Services| Published January 15th, 2018 Medicare's MLN Matters Number: MM10176 was recently revised to identify services subject to their therapy cap. The revision became effective on January 1, 2018 and some providers have begun to receive claim rejections because they are not using the appropriate modifier. The article states the following:
Services furnished under the Outpatient ... January 11th, 2018 Intensive Outpatient Treatment (IOP)| Published January 11th, 2018 Intensive Outpatient Programs (IOPs) are considered to be an intermediate level of care which is commonly considered after the patient has been discharged from inpatient care. For some patients and/or conditions they can also provide an effective level of care when hospitalization is not clinically indicated or preferred. The following ... January 9th, 2018 GeneSight Psychotropic Testing and Documentation| Published January 9th, 2018 According to Wisconsin Physicians Service Insurance Corporation, there is limited coverage for the GeneSight® Psychotropic (AssureRx Health, Inc, Mason, OH) gene panel. GeneSight® testing may only be ordered by licensed psychiatrists or neuropsychiatrists contemplating an alteration in neuropsychiatric medication for patients diagnosed with major depressive disorder (MDD) (in accordance with DSM IV/V criteria) who are suffering with refractory moderate to ... There are more articles. View all articles... View articles for the current specialty by subtopic: Select the webinar title to view a summary and link to the webinar video. April 10th, 2018 Liens and PI care — How to Make Them Work Better...Liens have been the salvation and anathema for doctors involved in personal injury care treatments. While an essential part of extending needed injury recovery care to those whose insurance coverage is minimal to non-existent, they are not a fool-proof way to secure reimbursement. How do you protect yourself against insurers and attorneys who refuse to honor the agreement? This webinar will explore various methods that have proven to be successful in enforcing a lien to secure reimbursement of your skillful services. January 4th, 2018 Proper Coding and Billing for Drugs, Biologicals and InjectionsProper Coding and Billing for Drugs, Biologicals and Injections February 2nd, 2017 How to Check NCCI Edits Using FindACodeHow to Check NCCI Edits Using FindACode 2020 Behavioral Health ICD-10-CM Cheat Sheet2020 Behavioral Health ICD-10-CM Coding Book2020 Behavioral Health Reimbursement GuideAdvanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolCMS Provider Minute: Psychiatry and PsychotherapyCommonly Used Medicare Modifiers - GA, GX, GY, GZERISA Topics PageFederal Opioid Treatment StandardsMedicare Part B Clinical Laboratory Fee ScheduleMedication and Counseling Treatment Insurance and Payments by SAMHSANational Council for Behavioral HealthNoridian Fee-for-Time Compensation Arrangements and Reciprocal Billing PoliciesNoridian Mental Health PoliciesNoridian Mental Health ResourcesNoridian: Allowed Amount ReductionsPhysician Assistant (PA) Resources NoridianSummary of the HIPAA Privacy Rule by HHS
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