Billing > Facility Billing

Behavioral health claims upfront denials from ANTHEM

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we are currently billing codes per Magellan since we are residential treatment center mental health but anthem not accepting these codes and deny inappropriate combination of revenue/CPT code.  specially for PHP mental health.

Would request you to please advise if you have any list of codes billing to ANTHEM for these services and claim not deny by them upfront.

Your question in the last sentence is worded odd so I'm really not sure what you are asking.  If you are asking for a list of codes that Anthem allows for residential treatment centers I do not have that available.  If you are receiving denials for specific rev codes/cpt codes and you post what those codes are we may be able to help.

"and claim not deny by them upfront"  -  I have no idea what you are asking with this statement.

Nick D:
Please provide the Type of Bill and HCPC/Rev combo you're using..


Revenue Code   CPT   Description
1001                H0017   RTC-MH
913                H0035   PHP-MH
905                 S9480    IOP-MH
300                 80305           UA
915                  90853   Group-MH

Bill Type: 863 for RTC-MH  , 893- PHP-MH, IOP-MH

So these must be on two separate claims if you are billing two different TOBs.  Are both claims being denied with the same reason?


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