The Provider Manual updates include changes in the following chapters:

Documentation

• Documentation for InterQual-Behavioral Health
• Behavioral Interventions for the treatment of Autism
• Child Psychiatric Residential Treatment Program
• Psychiatric Partial Hospital Program
• Substance Use Disorder Residential Treatment Program
• Substance Use Disorder Partial Hospital Program
• Adult Psychiatric Residential Treatment Program

New chapter additions

• Diabetes Prevention Program

The following chapters have been updated or relocated due to new reimbursement policies or notices.

• Hospice Services
• Home Medical Equipment
• Dialysis
• Home Infusion Therapy
• Home Health Services
• Inpatient- Skilled Nursing Facility Billing
• Inpatient Swing Bed- Hospital Billing
• Inpatient Transitional Care Unit- Hospital Billing
• Endoscopy
• Hospital Outpatient
  • Surgical Roll-up methodology
  • Trauma Activation
• Acute Inpatient (APR-DRGS) Hospital Billing
• Behavioral Health Inpatient Acute (APR DRGS)- Institutional Billing
• Ambulance

As a reminder, reimbursement notices can be found in our fee schedule portal.