Medical Billing Forum

Coding => Coding => : terral_p March 30, 2011, 03:16:58 PM

: Methadone Insurance Billing
: terral_p March 30, 2011, 03:16:58 PM
Good Day,

We are trying to determine the CPT codes for Drug and Alcohol claiming for Insurance.  We are using the Medical H0020, with the HG modifier, however, we are unsure of what the CPT code for the Insurance company should be.  Due to Gross MediCal billing we want to make sure we have accurately claimed the services to Insurance prior to claim to MediCal.

Would appreciate any guidance.  Thanks
: Re: Methadone Insurance Billing
: Michele March 31, 2011, 12:06:49 PM
Can't really help with the information that you are giving.  There are many different ways of treating Drug & Alcohol services and each has coding.  There isn't one 'universal' code.  It would depend on the services that are being provided.

: Re: Methadone Insurance Billing
: terral_p March 31, 2011, 01:13:11 PM
My apologies the three types services would be:

METHADONE MAINTENANCE/SITE       
METHADONE MAINTENANCE/COURTESY 
TAKE HOME METHADONE MAINTENANCE

For California they are all Mode 15, SFC 20

Does this help?

Thanks


: Re: Methadone Insurance Billing
: Michele April 01, 2011, 04:30:30 PM
Not really, they sound like internal descriptions.  Are you billing on CMS forms or UB04's?  What are the actual services?  Counseling?