Billing > Facility Billing

PHP & IOP substance abuse billing, HELP!


I am fairly new to substance abuse billing and am in a rut that I can't seem to find my way out of.  I haven't had any problems with my RTC claims because they haven't required any HCPCS info but my PHP and IOP claims are a different story.  I am using rev codes 0913 (PHP) with HCPC H0035 and rev code 0906 (IOP) with HCPC H0015 and I am not able to get them passed the clearing house level, they are all rejecting there.  The only info that they will give me back is that I have missing or invalid information between boxes 42 - 49.  My entire claim is filled out the same as an RTC claim other than these boxes.  If anyone could help it would be greatly appreciated.  I am really in a time crunch.  Please and thank you!!!

Have you contacted the clearinghouse?  The denial is too vague to figure out what is wrong.  Someone at the clearinghouse should be able to give you more specific information.  The codes seem fine so nothing jumps out as being incorrect however without knowing more information it's impossible to tell.


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