Name of Manual - Blue Cross and Blue Shield of Minnesota

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Coding Policies and Guidelines (Behavioral Health) Individual Behavioral Health Therapy Family and Group Therapy 11-86 Revenue Code 0911 See HCPCS/ CPT for approp. code HCPCS Code Narrative Time Units Psychiatric/ Psychological service/rehabilitat ion. Do not use for CD services. 0912 H2012 Psychiatric/ Psychological service/partial hospitalization - less intensive 0914 See CPT codes for individual therapy Psychiatric/ psychological service/individual therapy Based on HCPCS/ CPT code used One line for each day the patient attends the program Based on CPT code used Depends on HCPCS/ CPT code used 1 unit for each hour the patient attends the program Depends CPT code used Use these codes when billing behavioral health family and group therapy services on an 837I claim format. Revenue Code 0915 See HCPCS/ CPT codes for group therapy 0916 90846 or 90847 0917 90875 or 90876 0918 96101- 96102, 96118- 96119 HCPCS Code Narrative Time Units Psychiatric/ Psychological service/group therapy Psychiatric/ Psychological service/family therapy Psychiatric/ psychological service/ biofeedback Psychiatric/ psychological service/testing Based on HCPCS/ CPT code used Per session Per session 60 minute code Depends on HCPCS/ CPT code used One unit per session One unit per session One unit per 60 minutes Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12
Substance Abuse Services Billing a Behavioral Health Assessment Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12 Coding Policies and Guidelines (Behavioral Health) The Minnesota Department of Health Minnesota Companion Guide includes a table showing the correct reporting of substance abuse services. See section A.5.3, Table 3, of the Minnesota Uniform Companion Guide for Institutional Claims at the following link http://www.health.state.mn.us/auc/instguide.htm. The table incorporates both institutional and professional claim types for ease of reference. 0912, 0944 or 0945 with 90801 or 90802 Bill 0912 and 90801/90802 with a mental health, chemical dependency or alcohol dependency diagnosis code Bill 0944 and 90801/90802 with a chemical dependency diagnosis code Bill 0945 and 90801/90802 with an alcohol dependency diagnosis Testing 0918 with 96101-96103, 96118-96125 Family Therapy 0916 with 90846 Testing is compatible with all behavioral health diagnosis codes. Revenue code 0916 and CPT 90846 is billed for family therapy when the patient is not present. There may be specific contract exclusions on for some self-insured groups. Revenue code 0916 and CPT 90846 should be billed under the specific patient, and not under the member. Bill one unit per session, regardless of total time. 0916 with 90847 Revenue code 0916 and CPT 90847 is billed for family therapy when the patient is present. There may be specific contract exclusions for some self-insured groups. Revenue code 0916 and CPT 90847 should be billed under the specific patient, and not under the member. Bill one unit per session, regardless of total time. 11-87
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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
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CTSS Skills Training and Developmen
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Intensive Residential Treatment Ser
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IRTS Member Eligibility IRTS Access
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Adult Non-Residential Crisis Servic
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MH-TCM Services to Minnesota Health
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Dialectical Behavioral Therapy/DBT
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Autism Spectrum Disorder/EIBI (cont
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Autism Spectrum Disorder/EIBI (cont
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Psychiatric Consultation to Primary
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Psychiatry and Chemical Dependency
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Medication Management M0064 and 908
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Nutritional Counseling/Medical Nutr
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Page 367 and 368: Coding Policies and Guidelines (Beh
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Portable Oxygen Billing (continued)
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Coding Policies and Guidelines (Dur
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DME/Supply Internet Purchases Codin
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Coding Policies and Guidelines (Hom
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Elderly Waiver Program (continued)
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Referrals and Prior Authorization (
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Referrals and Prior Authorization (
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Adult Day Care Bath Services Coding
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Home Infusion (continued) Coding Po
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Coding Policies and Guidelines (Hom
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Rules and Regulations (continued) H
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Hospice Billing for Medicare Produc
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Coding Policies and Guidelines (Hos
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Coding Policies and Guidelines (Lab
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Papanicolaou Smears (continued) Dia
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Blue Cross and Blue Shield of Minne
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Coding Policies and Guidelines (Mat
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Coding Policies and Guidelines (Med
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Coding Policies and Guidelines (Opt
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Coding Policies and Guidelines (Pha
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Drugs Coding Policies and Guideline
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Drug Programs Coding Policies and G
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Coding Policies and Guidelines (Pub
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Coding Policies and Guidelines (Rad
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Physical Therapy Evaluation Codes C
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Hot and Cold Pack Exclusion TMJ Ort
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Massage and Manual Therapy Exclusio
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MHCP PT, OT, ST Authorization Proce
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Bilateral Services (continued) Codi
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Coding Policies and Guidelines (Sur
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Acne Treatment/ Skin Rejuvenation a
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Liposuction Edit Change Coding Poli
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Assistant Surgeons (continued) Assi
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Coding Policies and Guidelines (Sur
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