Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Behavioral Health)
11-2
Clinical Supervision Under Minnesota Rule Part 9505.0371 - MHCP Members Only.... 11-39
DIAMOND Initiative ........................................................................................................ 11-40
Marital Counseling ............................................................................................................ 11-41
Opioid Maintenance Drug Therapy................................................................................... 11-41
Tobacco Cessation............................................................................................................. 11-42
Rule 29 Setting .................................................................................................................. 11-43
Day Treatment................................................................................................................... 11-43
Compatibility..................................................................................................................... 11-43
Health and Behavior Assessment and Intervention Codes................................................ 11-44
Missed Appointments........................................................................................................ 11-44
Court Ordered Treatment .................................................................................................. 11-45
Guidelines for Court Ordered Evaluations........................................................................ 11-46
Guidelines for Court Ordered Evaluations – Noncovered Services.................................. 11-49
Parity.................................................................................................................................. 11-51
Behavioral Health Quality Improvement Objectives ........................................................ 11-51
Prior Authorization............................................................................................................ 11-53
Referrals ............................................................................................................................ 11-54
Preadmission Notification ................................................................................................. 11-54
Pre-certification and Concurrent Review for Inpatient/Residential Mental Health and
Substance use Disorder Services....................................................................................... 11-55
Groups that Carve Out Behavioral Health Benefits .......................................................... 11-56
Provider Networks............................................................................................................. 11-57
Professional Behavioral Health Coding Information..........................................................11-59
Behavioral Health for Institutional (837I) Billers ...............................................................11-85
Introduction ....................................................................................................................... 11-85
Practitioners Who Should be Using this Section............................................................... 11-85
Coding Guidelines............................................................................................................. 11-85
Behavioral Health Evaluation or Testing .......................................................................... 11-85
Units .................................................................................................................................. 11-85
Individual Behavioral Health Therapy .............................................................................. 11-86
Family and Group Therapy ............................................................................................... 11-86
Substance Abuse Services ................................................................................................. 11-87
Billing a Behavioral Health Assessment ........................................................................... 11-87
Testing ............................................................................................................................... 11-87
Family Therapy ................................................................................................................. 11-87
Nutritional Counseling/ Dietitians..................................................................................... 11-88
Detox and Alcohol/Drug Rehab Services.......................................................................... 11-89
Health and Behavior Assessment and Intervention Codes................................................ 11-89
Non-Residential Treatment Centers .................................................................................. 11-90
FEP Exclusion of Residential Treatment Centers ............................................................. 11-90
Compatibility..................................................................................................................... 11-90
Recreational Therapy......................................................................................................... 11-90
Extended Care and Halfway House Room and Board (Medicaid Government Programs
Only).................................................................................................................................. 11-91
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12