Name of Manual - Blue Cross and Blue Shield of Minnesota

Detox and
Alcohol/Drug Rehab
Services
Health and Behavior
Assessment and
Intervention Codes
0116, 0126, 0136, 0146, 0156
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12
Coding Policies and Guidelines (Behavioral Health)
Detox is a medically supervised treatment program for alcohol or
drug addiction designed to purge the body of intoxicating or
addictive substances. Detox is a medical service that treats
physiological issues. When during this detox process the patient is
not able to participate in a substance abuse treatment program,
detox services are payable out of medical benefits, not substance
abuse benefits. It would be appropriate to bill primary diagnosis
code 980.9 when submitting alcohol detox services. It would be
appropriate to bill primary diagnosis code 977.9 when submitting
chemical/drug detox services.
Bill one unit of service per night spent in a detox bed.
When billing therapy/treatment services such as revenue code
0944 (drug rehabilitation) or 0945 (alcohol rehabilitation,) a
chemical dependency or alcohol dependency diagnosis code
must be submitted. These services are payable out of substance
abuse benefits if the patient’s policy has substance abuse
benefits.
If a patient’s policy does not have a substance abuse benefit,
only room and board charges are eligible, typically billed under
revenue code 0126. Detox services will not be paid if billed in
conjunction with a therapy service such as revenue code 0944
or 0945.
If a patient’s policy does have a substance abuse benefit, then
both room and board and therapy charges are eligible.
Detox does not accumulate towards policy limitations.
Detoxification services are eligible when they are provided in a
state licensed freestanding detoxification center, a hospital or a
residential treatment center.
96150-96155
CPT codes 96150-96155 describe services offered to patients who
present with established illnesses or symptoms and who are not
diagnosed with mental illness. The primary diagnosis should be a
non-behavioral health diagnosis code. Codes 96150-96155 should
not be reported with revenue codes 0900-0919 on facility claims.
Codes 96150-96155 may be submitted under revenue code 0940.
11-89