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detox assessments and type of bill

I am new to the substance abuse field and you seen to have a lot of experience. I switched over from cardiology, integ, and podiatry and am now billing for a detox facility, residential and php facility. I was curious if you could help me with two things.

First where can i find the type of bill code for box 4 required for bc claims? I have been searching all over their website and can’t find anything. I read one thread that said to use 11X but i’m not sure if that’s correct or if it would be 86X since we are not a hospital?

The other question I have is the previous billing company was billing intake assessments with the code H0001 and H0002 and they are all denied from all the insurance companies or reimbursing at a really low rate. Would I be able to use an e/m code such as 99408 or 99409? or is there a better code for an initial assessment and also a discharge assesment?

I would really appreciate the help.
Thank you
Sarah CPC
you can respond on here or feel free to email me at [email protected]

Medical Billing and Coding Forum

BH Assessments – ER Diagnosis Codes

I code for BH and I receive BH assessments (completed by LSCSW) in the ER. I am having issues with the diagnosis coding.

On one hand there are the diagnoses, signs, and symptoms the patient (or outside source) reports. On another hand the LSCSW reports different (or the same) diagnoses in the EMR – note I also receive paper tickets for these encounters. Then on my paper tickets the LSCSW writes down a different (or the same) diagnoses than what is in the EMR.

These assessments are detailed and can have conflicting information from the many persons involved in the patients care. What should I do? I don’t want to code these incorrectly. The conflicting information makes my head spin. What all should I be taking into account? Who should I be taking into account when assigning the diagnoses? :confused:

Any help is appreciated!

Medical Billing and Coding Forum

mental health assessments

A general question has sparked some investigation in regards to mental health assessments. What do you feel exactly qualifies an encounter for the health and behavioral assessment. Do you feel the 96150 falls under the "mental health" or "general health", the book states this as general health. I am just curious of others thoughts??

Thank you

Medical Billing and Coding Forum

possible limits on billing 96127 emotional/behavioral assessments

My new boss says that we can only bill for these assessments once per patient. I see that we are allowed only 2 units on a claim but I can’t see anywhere where it says bill only once per patient. Anybody out there have any other info on this?

Medical Billing and Coding Forum