Unit Four: Systems Oriented Practice
Chapter 18: Billing and coding
Unit Four: Class Three
Learning Objectives
4.3.1. Define who qualifies under the Access to Care Standards and coverage limitations (PRISM score, GAIN score, GAF level, ICD-10s covered, other).
4.3.2. Explain how to assign the appropriate level of CPT code with the service provided.
4.3.3. Describe how to utilize WA State fee schedules to assign CPT codes to services provided.
4.3.4. Explain how the prior authorization process works and which services may require this process before providing care or referrals.
Reading Assignments
Online Articles:
- Tips and Strategies for Billing for Mental Health Services in a Primary Care Setting; Suicide Prevention Resource Center (SPRC)
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UW AIMS Center, “Dollars and Sense” Resources
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Washington Billing Worksheet; SAMHSA
- Same Day Billing for Mental Health Services and Primary Care Services; American Medical Association, ICN 908978, 9/2013
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When Available – North Sound Payment Redesign Information
- Link: http://www.nsach.org/payment-redesign-2/
