Author Topic: inpatient facility drug and alcohol rehab billing  (Read 4973 times)

Jen99

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inpatient facility drug and alcohol rehab billing
« on: April 16, 2010, 03:57:02 PM »
I am brand new to facility billing.  I have a client who is a inpatient drug and alcohol center.  They want me to provide them with a UB04 for each patient.

Do you need to have the individual providers NPI number along with the facility NPI number on the form?

Do you not use any CPT codes?

Don't know much about Rev codes help would be nice?


blhoffman

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Re: inpatient facility drug and alcohol rehab billing
« Reply #1 on: April 16, 2010, 11:31:05 PM »
What state are you in?

I found this information for NY that might be helpful to you.

http://www.oasas.state.ny.us/admin/hcf/BillingCodes.cfm


Michele

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Re: inpatient facility drug and alcohol rehab billing
« Reply #2 on: April 18, 2010, 12:59:20 PM »
You need to put the name and NPI of the attending physician (provider).  You actually use rev codes to indicate the service, but there is also a place to enter the appropriate CPT code that corresponds with the rev code you are billing.

If you have never completed a UB04, we have a manual that goes thru the form box by box and also contains a list of rev codes.  More info at http://www.medicalbillinglive.com/UB04-forms-book.shtml

Good luck

Michele
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Jen99

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Re: inpatient facility drug and alcohol rehab billing
« Reply #3 on: April 18, 2010, 03:16:35 PM »
I am in CA and so is the facility.

I do have the book you made on UB 04, Michelle it is awesome and has helped me alot.

So I am understanding how to do the form much more then before.  I do have a few questions

The patient is in the rehab inpatient facility for about 30 days.  And during that stay they see a multiple of providers but the same Rev code and CPT code can I put the first service date and then do the service units as how many times that Rev code was used during the stay.  Or since it was on different DOS just list each DOS on a seperate line with 1 service unit.

Do you always have to have a CPT code to go along with the revune code?

If the patient is seen by 5 different providers should you do one UB 04 for for each provider.

Since It is an inpatient rehab facility would my bill code be 891?

Not sure about the Value codes the list doesnt look like things apply to my type of billing.

When you bill the rev code 0128 do you include anything else with it, cpt or total charge?


Michele

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Re: inpatient facility drug and alcohol rehab billing
« Reply #4 on: April 19, 2010, 07:08:28 AM »
You can bill the whole 30 days on one form.  You don't have to list each provider they say.  Usually there is one that is 'in charge' of the patient's care.  For example a dr or psychiatrist is overseeing all care, but the patient sees several counselors during their stay.  Not all rev codes have corresponding cpt codes, such as the room & board rev codes.  I never used value codes when doing inpatient rehab.  As for the type of bill, some insurance carriers may require a different type of bill than another carrier, but the 891 looks appropriate.  You may also want to look at 861.


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Jen99

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Re: inpatient facility drug and alcohol rehab billing
« Reply #5 on: April 19, 2010, 10:52:23 AM »
So when I bill the rev code 0128 do I need to put a fee attatched to it?  I am not sure about what rev code to use with CPT code 99403, 96101,90818.  Do you know the code CPT code for Acupuncture or massage?

Michele

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Re: inpatient facility drug and alcohol rehab billing
« Reply #6 on: April 19, 2010, 01:29:40 PM »
If you want to be paid for the 0128 then you need to put the fee in box 47.  Massage is 97124, acupuncture codes are 97810-97814.  Rev code for 96101, try 0918.  90818 try 0909, and 99403 try 0770 or 0779.

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Jen99

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Re: inpatient facility drug and alcohol rehab billing
« Reply #7 on: April 19, 2010, 09:55:47 PM »
Michele,

I appreciate all your help and advice you are giving me. 

So for Rev code 0128 that is the type of room and board (semiprivate two bed)

Do I need to bill a CPT code along with it? 


What is your experince with insurance compaines paying for inpatient drug rehab?  Do they pay for the room and board?  This will be my first claim I send out and I need to figure out a price for the client.

Michele

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Re: inpatient facility drug and alcohol rehab billing
« Reply #8 on: April 20, 2010, 07:14:20 AM »
There is no cpt code that corresponds with 0128.  The payment will depend on several things, if the facility is in network, and the plan.  Each plan varies and will define if they cover inpatient D&A rehab so it will vary from patient to patient.  If the provider is out of network they usually pay the patient directly, which in these cases can make it difficult.  Most out of network facilities require payment from the patient up front.

Michele
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