Name of Manual - Blue Cross and Blue Shield of Minnesota

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Professional Behavioral Health Coding Information Blue Cross and Blue Shield of Minnesota and Blue Plus Code Description Units Who May Submit Misc 90801 Psychiatric diagnostic interview exam 1 per session MD, LP-PhD., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 90802 Interactive diagnostic interview exam 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 90804 Individual psychotherapy, insight oriented, office/outpatient, 20-30 min. 90805 Individual psychotherapy, insight oriented, office/outpatient, 20-30 min., w/E/M 90806 Individual psychotherapy, insight oriented, office/outpatient, 45-50 min. 90807 Individual psychotherapy, insight oriented, office/outpatient, 45-50 min., w/E/M 90808 Individual psychotherapy, insight oriented, office/outpatient, 75-80 min. 90809 Individual psychotherapy, insight oriented, office/outpatient, 75-80 min., w/E/M 90810 Individual psychotherapy, interactive, office/outpatient, 20-30 min. 90811 Individual psychotherapy, interactive, office/outpatient, 20-30 min., w/E/M 90812 Individual psychotherapy, interactive, office/outpatient, 45-50 min. 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 1 per session MD, CNS-Psych, PMHNP 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 1 per session MD, CNS-Psych, PMHNP 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 1 per session MD, CNS-Psych, PMHNP 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC 1 per session MD, CNS-Psych, PMHNP 1 per session MD, LP-Ph.D., LP-MA, LICSW, CNS- Psych, PMHNP, LMFT, LPCC Coding Policies and Guidelines (Behavioral Health) Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12 11-59
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Blue Cross and Blue Shield of Minne
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Recent Chapter changes: Chapter 11
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Chapter 11 - Coding Policies and Gu
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Durable Medical Equipment Date Topi
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Medical Emergency Date Topic Change
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Rehabilitative Services Date Topic
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Table of Contents Chapter 1 At Your
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Introduction Provider Policy and Pr
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How to Contact Us At Your Service P
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At Your Service Claims Address Subm
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Care Management Numbers and Address
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Care Management Numbers and Address
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Company Phone Number Address Public
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At Your Service Provider Identifica
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ID Cards At Your Service Introducti
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Electronic Commerce Overview An imp
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Remote Access Services (continued)
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Provider Communications Provider Co
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Health Plan Members have the Follow
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Provider Agreements Participation a
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Provider Agreements Responsibilitie
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Provider Agreements Provider Number
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Provider Agreements Accounting for
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Provider Agreements Carrier Replace
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Table of Contents Chapter 3 Quality
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Quality Improvement Leadership Rati
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Quality Improvement Telephone Care:
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Quality Improvement Quality of Care
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Quality Improvement Written Policie
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Quality Improvement Written Policie
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Quality Improvement Patient Safety
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Quality Improvement Medical Record
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Quality Improvement Institute for C
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Quality Improvement Quality Improve
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Quality Improvement Physical Facili
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Quality Improvement Treatment Recor
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Integrated Health Management Progra
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Integrated Health Management Provid
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Integrated Health Management Utiliz
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Integrated Health Management Medica
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Integrated Health Management Overvi
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Integrated Health Management Pre-Ce
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Integrated Health Management Decisi
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Integrated Health Management Defini
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Integrated Health Management For Lo
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Integrated Health Management Appeal
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Integrated Health Management Case &
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Integrated Health Management Diseas
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Integrated Health Management Focuse
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Integrated Health Management Specia
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Integrated Health Management Overvi
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Integrated Health Management Sample
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Health Care Options Prepaid Medical
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Health Care Options Member ID Cards
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Health Care Options Blue Cross and
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Health Care Options Double Gold Dou
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Health Care Options Medicare Basic
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Health Care Options Platinum Blue S
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Health Care Options MedicareBlue PP
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Health Care Options Inquiries and C
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Health Care Options Additional info
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Health Care Options Minnesota Senio
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Health Care Options MinnesotaCare P
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Health Care Options BlueLinkTPA Blu
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Health Care Options Delta Dental Hi
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Health Care Options Prime Therapeut
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Health Care Options Workers' Compen
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Health Care Options HICF 1500 Form
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Health Care Options Networks Blue C
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Blue Plus Member Information Introd
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Blue Plus Member Rights and Respons
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Blue Plus Member Rights and Respons
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Blue Plus Member Benefits Members
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Blue Plus Quality of Care Complaint
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Blue Plus Referral Points Remember
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Blue Plus Referral Not Required We
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Blue Plus Standing Referral Minneso
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Blue Plus Clarifications of Terms (
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Blue Plus [Date] [Name of patient]
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Blue Plus Special Member Benefits O
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Blue Plus OB/GYN Open Access Diagno
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Blue Plus OB/GYN Open Access Diagno
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BlueCard® Claim Status Inquiry ...
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BlueCard® Identifying BlueCard ®
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BlueCard® Identifying BlueCard ®
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BlueCard® BlueCard Service Claims
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BlueCard® Prior Authorization and
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BlueCard® Electronic Data Intercha
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BlueCard® Claims Processed by the
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BlueCard® Overview (continued) 3.
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BlueCard® Claim Payment Guidelines
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BlueCard® Calls from Members and O
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BlueCard® Guidelines (continued) W
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BlueCard® Types of Medicare Advant
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BlueCard® Medicare Advantage Claim
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BlueCard® Reimbursement for Medica
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Claims Filing HCPCS/ Accommodation
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Claims Filing Administrative Simpli
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Claims Filing Claims with Attachmen
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Claims Filing Claims with Coordinat
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Claims Filing Claims with Coordinat
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Claims Filing 1500 HICF Form Profes
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Claims Filing Ordering Forms and Ma
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Claims Filing Site of Service (cont
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Claims Filing Institution (837I) /F
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Claims Filing Treatment Room Blue C
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Claims Filing Single facility claim
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Claims Filing Present on Admission
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Claims Filing Medicare Crossover Bl
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Claims Filing Cancel/Void and Repla
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Claims Filing Verifying Patient Eli
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Claims Filing Basic Character Set V
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Claims Filing Rural Health Clinics
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Claims Filing Coordination of Benef
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Claims Filing TEFRA The 1982 Tax Eq
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Claims Filing Employment As defined
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Claims Filing Surgical Technicians
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Reimbursement / Reconciliation Reim
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Reimbursement / Reconciliation Comp
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Reimbursement / Reconciliation Remi
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Reimbursement / Reconciliation Ques
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Reimbursement / Reconciliation Ques
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Reimbursement / Reconciliation Acco
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Reimbursement / Reconciliation Fiel
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Appeals Provider Appeals Introducti
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Appeals Submitting Requests for Pos
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Appeals Coding Appeals (continued)
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Appeals Supporting Documentation (c
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Coding Policies and Guidelines (Cod
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Coding Policies and Guidelines (Cop
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Coding Policies and Guidelines (Mod
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Chapter 11 Coding Policies and Guid
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Part-time (Medically Directed) Anes
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Electroconvulsive Treatments Blue C
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Moderate (Conscious) Sedation Monit
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Coding Policies and Guidelines (Beh
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Coding Restrictions Code Restrictio
Page 339 and 340: CTSS Skills Training and Developmen
Page 341 and 342: Intensive Residential Treatment Ser
Page 343 and 344: IRTS Member Eligibility IRTS Access
Page 345 and 346: Adult Non-Residential Crisis Servic
Page 347 and 348: MH-TCM Services to Minnesota Health
Page 349 and 350: Dialectical Behavioral Therapy/DBT
Page 351 and 352: Autism Spectrum Disorder/EIBI (cont
Page 353 and 354: Autism Spectrum Disorder/EIBI (cont
Page 355 and 356: Psychiatric Consultation to Primary
Page 357 and 358: Psychiatry and Chemical Dependency
Page 359 and 360: Medication Management M0064 and 908
Page 361 and 362: Nutritional Counseling/Medical Nutr
Page 363 and 364: Coding Policies and Guidelines (Beh
Page 369 and 370: Practitioner Key MD = Psychiatrist
Page 371 and 372: Clinical Supervision Under Minnesot
Page 373 and 374: DIAMOND Initiative (continued) Reim
Page 377 and 378: Missed Appointments (continued) Cou
Page 379 and 380: Guidelines for Court Ordered Evalua
Page 381 and 382: Guidelines for Court Ordered Evalua
Page 385 and 386: Behavioral Health Quality Improveme
Page 387 and 388: Pre-certification and Concurrent Re
Page 389: Coding Policies and Guidelines (Beh
Page 393 and 394: Code Description Units Who May Subm
Page 419 and 420: Substance Abuse Services Billing a
Page 421 and 422: Detox and Alcohol/Drug Rehab Servic
Page 423 and 424: Extended Care and Halfway House Roo
Page 425 and 426: Extended Care and Halfway House Roo
Page 427 and 428: Rule 5 - Emotionally Handicapped Fa
Page 429 and 430: IRTS (Medicaid Government Programs
Page 431 and 432: Court Ordered Treatment (continued)
Page 433 and 434: Pre-certification and Concurrent Re
Page 435 and 436: Groups that Carve Out Behavioral He
Page 437 and 438: Blue Cross and Blue Shield of Minne
Page 439 and 440: Chapter 11 Coding Policies and Guid
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Examination Codes (continued) Chiro
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Coding Policies and Guidelines (Chi
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Radiology Coverage Restriction Prac
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Documentation Guides (continued)
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MHCP Chiropractic Authorization Pro
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Coding Policies and Guidelines (Den
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Coding Policies and Guidelines (Den
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Coding Policies and Guidelines (Dur
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Coding Policies and Guidelines (Hom
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Hospital Observation Services Obser
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SNF Billing for Blue Plus Governmen
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SNF Billing for Blue Plus Governmen
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Leave of Absence (LOA) or Furlough
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Coding Policies and Guidelines (Lab
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Submission Options and Coding Alter
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Two Physicians Involved in Care/ Sa
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Obstetrical Care Coding Alternative
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Reproduction Treatment (continued)
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Emergency Department Services Codin
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Evaluation and Management (E/M) Cod
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Evaluation and Management (E/M) (co
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Office or Other Outpatient and Init
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Preventive Medicine (continued) Cod
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Chemotherapy Administration Coding
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CHF Telemonitoring (continued) Bill
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CHF/COPD Telemonitoring Services fo
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E-Care Visits (continued) Qualifyin
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E-Care Visits (continued) Not Cover
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Coding Policies and Guidelines (Med
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Immunizations (continued) Code Use
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Immunizations (continued) Coding Po
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Billing Options for Medicare Part D
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Nicotine Dependence (continued) Rev
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Medication Therapy Management (MTM)
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Practitioners That ARE Credentialed
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Prolonged Physician Services Coding
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CODING (continued) Remote Clinic or
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Weight Management Care (continued)
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Weight Management Care (continued)
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Assessment Management Program for F
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Health Care Home (HCH) Health Care
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Health Care Home (HCH) (continued)
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Vision Therapy Services Claims Fili
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Coding Policies and Guidelines (Pha
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C&TC Component Commonly Billed Code
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Public Health Nursing Services Codi
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Interpretive Services (continued) B
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Blue Plus Contracted Interpreter Ag
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Blue Cross and Blue Shield of Minne
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Community Health Workers Coding Pol
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Hearing Aid Fee Schedule Update Cod
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GenRx Formulary (continued) Formula
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Formulary Exception Process (contin
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Chiropractic, Physical, Occupationa
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Chiropractic, Physical, Occupationa
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Services to Restricted Recipients (
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Prior authorization changes Coding
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Special Transportation Special Tran
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Radiation Treatment Management Code
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High-Technology Diagnostic Imaging
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High-Technology Diagnostic Imaging
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Coding Policies and Guidelines (Reh
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Coding Policies and Guidelines (Sur
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