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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Medical Care at Psychiatric Residential Treatment Facility

We have a physician from our outpatient office travelling to our Psychiatric Residential Treatment Facility to provide non-mental health E/M services when requested. I am having a hard time defining The PRTF to select a code for this. I’ve tried to research what category this location would fall under and can’t find much.

Would I consider the PRTF to be a nursing facility?

Would this be considered a consultation because this physician is providing medical care not related to their mental health? Or would I code as regular E/M for the location type?

Any help is appreciated!

Medical Billing and Coding Forum

Billing Room and Board for Residential Treatment

HCPCS H0019 excludes Room and Board so how do you bill for the Room and Board for LOC 3.3 or 3.5 Long Term Residential Substance Abuse Treatment?

Or is there a different HCPCS code to use that includes Room and Board?

Another pressing question that I need an answer to as soon as possible.

I have spent a large amount of time researching this and can’t find this anywhere.

Thxs.

Medical Billing and Coding Forum

substance abuse assessment and type of bill questions for detox and residential

Please help

I am new to the substance abuse field and have a few things I wanted to run by anyone who is willing to help. 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

Behavioral Health & Substance Abuse Residential Facility

Have a client in our residential treatment program which we bill services with Revenue Code 1001. Client left facility at 11:30pm yesterday and transported to ER, has not returned yet. Question…can we bill the 1001 for yesterday even though they were not there after midnight?

Thank you!!

Medical Billing and Coding Forum

Residential Substance Abuse Billing – MN

Hello! Question in regards to billing for residential substance abuse billing in Minnesota. We bill the H2036 for the treatment plan which includes all the clients groups for the day. I’m told the client has to attend 30 hours of groups per week and our clients do this between Monday-Friday. There are no groups on the weekend so there are no progress notes for the weekend dates (only if the HST updates something in their record). Are we allowed to bill for Saturday and Sunday dates when there are no groups? Room and board is a separate line.

Medical Billing and Coding Forum

Blue Shield Codes- Residential Facility-Sub Acute

I wanted to share this info with anyone interested.
The below codes have been paying very very well with Blue Shield…

S0201 (HC svc qual), 0900, 897*
H0010, (HC svc qual)0101, 867*
H0018, (HC svc qual)0100, 867
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Medical Billing and Coding Forum

Alcohol and Drug Abuse Residential Treatment Facility

I work for a new facility that provides individual and group counseling for substance abuse and co-occurring disorders. There are medical and behavioral health staff whom provide treatment. It is a 24-hour facility (not a hospital) and the length of stay varies from 30-90 days.

I am looking to connect with others who are familiar with billing for these types of facilities. What is the appropriate code to use for billing the facility daily charge? The code range I am looking at is H0010 – H0019. I also see revenue codes 1002 (Residential Treatment Chemical Dependency) and 906 (Behavioral Health Treatments/Services Chemical Dependency).

Any assistance would be greatly appreciated.

Medical Billing and Coding Forum

Alcohol and Drug Abuse Residential Treatment Facility

I work for a new facility that provides individual and group counseling for substance abuse and co-occurring disorders. There are medical and behavioral health staff whom provide treatment. It is a 24-hour facility (not a hospital) and the length of stay varies from 30-90 days.

I am looking to connect with others who are familiar with billing for these types of facilities. What is the appropriate code to use for billing the facility daily charge? The code range I am looking at is H0010 – H0019. The sub-acute detoxification residential inpatient (H0010) seems to fit. I also see revenue code 1002 (Residential Treatment Chemical Dependency).

Any assistance would be greatly appreciated.

Medical Billing and Coding Forum