The Provider Manual updates include changes in the following chapters:
Documentation:
- Documentation Guide 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.