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Substance Abuse Facility

Hello everyone,

After recently being hired at free standing substance abuse/mental health facility as a head biller, I’ve found some mistakes. Coming from a company who was contracted to bill for substance abuse and mental health facilities, I believe I am correct, but I could be wrong.

The facility uses bill type 131, not 073x. They are not a hospital, so should we use 073x or 131?

They bill CPT codes on a UB04 claim. Is this correct? I’ve never done this and it seems rather odd.

They uses HCPCS code H0035 (mental health) for substance abuse PHP. I’ve used a different one, S0201 (substance abuse). They see substance abuse patients. Which is correct?

The co owner wants to leave things as they are because she wants to keep the flow of money continuos but I’ve let her know that if she gets audited, she can get in trouble. Does anyone have any tips or can anyone provide guidance? Help! Thank you in advance.

Medical Billing and Coding Forum | AAPC