We’ll admit it: Medical coding and billing aren’t the most entertaining parts of addiction treatment.
But without rock solid coding, your claims—and your center—aren’t going to succeed.
Your addiction treatment center’s coding game is only as strong as the humans doing the coding. The good news is that a fool-proof EHR with a built-in billing service (like the one we’ve created at BehaveHealth) can stop most of these common mistakes before they even happen.
Today, let’s learn about the top 5 mistakes your treatment center is probably making right now and how they can be fixed—for good.
Addiction Treatment Coding Error #1: You’re Failing to Gather Enough Patient Data
Simply put, if your CPT code isn’t backed up with the correct ICD-10 code, your claim isn’t going to pass muster. (Confused? Remember, the ICD-10 code describes the diagnosis. The CPT code describes the treatment. CPT codes are justified by ICD-10 codes.)
Many addiction treatment centers make the mistake of using the same CPT code for every single patient. This is going to cause problems when some patients need a higher level of care than others. Referring to a handy chart like this one can help your clinicians assign the right ICD-10 code to the right patient.
Addiction Treatment Coding Error #2: Your Coders Aren’t Up to Date
Codes change frequently. It can be hard to keep up.
Without an EHR that automatically updates codes (like the one at BehaveHealth), it’s easy to miss code updates and submit claims with outdated codes.
The best way to avoid this is to be sure you are using a frequently-updated EHR system that is designed for the addiction treatment industry specifically.
At BehaveHealth, we are constantly on the lookout for any changes to billing codes (as well as laws and regulations) that affect the addiction treatment industry. When you choose BehaveHealth, these changes will be effortlessly integrated into your operations as soon as they happen.
Addiction Treatment Coding Error #3: Management Isn’t Learning From Mistakes
Even with all of your best efforts, mistakes will be made. What you do with those errors is critical.
Well-managed addiction treatment billing departments will learn from these mistakes and view them as opportunities for improvement. They will examine the patterns behind claims denials and introduce system edits to address those problems. They will focus on educating clinicians and maintaining an up-to-date billing force.
Poorly managed addiction treatment billing departments will fail to identify error patterns and will make the same mistakes again and again.
If your organization falls into the “poorly managed category,” don’t despair. It’s important to note that, in many cases, “poor management” doesn’t mean bad managers. More often than not, it just means that there’s not enough internal bandwidth in your organization to appropriately manage a complex billing environment. In these cases, outsourcing billing is a smart move.
Addiction Treatment Coding Error #4: You’re Upcoding
It’s never a good idea to bill for more services than you are actually offering, but this is a fairly common—and very risky—practice in the addiction treatment industry, as with all medical fields.
For example, some addiction treatment counselors will consistently bill for 30 or 60 minute counseling sessions that are actually only 10 or 15 minute check-ins. This is upcoding.
At BehaveHealth, we strongly urge providers to avoid upcoding. Not only is it inaccurate, it’s dangerous. Upcoding opens up your addiction treatment center to a world of hefty liability if the government identifies a pattern of inaccuracies in your billing department.
Addiction Treatment Coding Error #5: Your Telemedicine Codes are a Mess
Especially now in the time of the coronavirus pandemic, our industry is moving to expand its telemedicine capabilities. Luckily, many forms of addiction treatment are uniquely suited to telemedicine.
That said, telemedicine brings its own coding challenges. Improper coding modifiers for telemedicine will delay reimbursements at a time when cash flow is vital to the business community at large. Sorting out GT and GQ modifiers will be a struggle for organizations that are new to providing remote treatment.
At BehaveHealth, we’ve got updated telemedicine codes built in to our system so you can start using them without delay.
There’s Never Been a Better Time to Clean Up Your Coding
Good coding starts with an EHR that resolves coding errors before they become a billing department problem. Give BehaveHealth a try today and see how our all-in-one cloud-based software solution for addiction treatment providers can resolve your coding errors today. Claim your free trial here.