Medical Billing Forum
Billing => Billing => : jessika1803 June 07, 2013, 04:20:09 PM
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I was wondering if someone can help me. We are starting IOP therapy for substance abuse at our clinic and I'm not very familiar with this. Can someone help guide me on the codes we would use or where I can find this information out?
Thanks
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Are you billing on CMS 1500's or UB04's?
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IOP stands for intensive outpatient programs. It represents an approach to addiction treatment at a level of intensity that is intermediate between intensive inpatient treatment and traditional outpatient treatment. This programs/billing require preauthorization from the insurance carrier.
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IOP Billing has various reimbursement program such as
Clinic Treatment Program - designated mental illness diagnosis
Continuing Day Treatment Program - designated mental illness diagnosis and dysfunction due to mental illness
Day Treatment Program for Children - designated mental illness diagnosis, plus either an extended impairment in functioning due to emotional disturbance or a current impairment in functioning with severe symptoms
Intensive Psychiatric Rehabilitation Treatment Program - designated mental illness diagnosis, dysfunction due to mental illness which is likely to continue for a prolonged time, readiness to participate in the program, and referral by a licensed practitioner
Partial Hospitalization Program - designated mental illness diagnosis which has resulted in dysfunction due to acute symptomatology which requires medically supervised intervention to achieve stabilization and which, but for the availability of a partial hospitalization program, would necessitate admission to, or continued stay in, an inpatient hospital
These programs are comes under IOP billing and they are non-medical program, which allow adults to participate in a psychotherapeutic program