There is no “best” addiction treatment diagnosis code (or ICD-10 code) to use when completing URs or authorizations with Healthfirst. All behavioral health diagnosis codes are subject to more or less the same utilization management decision making criteria at Healthfirst.
Where to Find Addiction Treatment Utilization Forms for L.A. Care Health Plan
How to Handle Utilization Reviews with Blue Shield of California for Addiction Treatment
While they’ve done things like make nominal financial contributions to the cause of diversifying the mental healthcare profession, Blue Shield of California is part of a general trend in managed care to minimize costs for insurers by limiting the scope of “medical necessity,” especially when it comes to addiction treatment.