MO HealthNet Provider Hot Tip of the Week
Behavioral Health Manual Update
November 24, 2015
On October 1, 2015, and after, MO HealthNet Division (MHD) claims will require an International Classification of Diseases (ICD), 10th Revision, and Clinical Modification/Procedure Coding Systems for codes reporting Mental, Behavioral, and Neurodevelopmental disorders. The Behavioral Health Services Manual has been updated reporting current ICD codes in the following sections.
- Section 13.24.B diagnosis codes:
In order to be reimbursed by MHD, the claim for the behavioral intervention must report one of the ICD codes provided in this section.
- Section 13.25.A Partial Early Periodic Screening and Diagnosis and Treatment (EPSDT)/Healthy Children and Youth (HCY) Screen:
The appropriate diagnosis codes for partial EPSDT/HCY screens are shown in this section. Section 13.25.A (1) shows a table demonstrating the procedure code, description, and maximum allowable reimbursement amount.
- Section 18.2 EPSDT/HCY screening services:
One of the following must report as the primary diagnosis on the claim: Z00110, Z00111, Z00121 or Z00129.
- Section 18.3 Behavioral Health Services:
The diagnosis code must be a valid ICD, current edition, diagnosis code and must be mental health or substance use disorder related. This does not include developmental disabilities. A table listing the ICD codes is provided in this section.
Centers for Medicare & Medicaid Services (CMS) provides many free tools and resources.
Archived Hot Tips
2015 Hot Tips
- Interactive Voice Response (IVR) System
- International Classification of Diseases (ICD) MO HealthNet Claim Filing Guidelines
- ICD-10 is Nearly Here!
- Non-Emergency Medical Transportation Program
- Claims Processing and Payment Schedule for Fiscal Year 2016
- Coverage for Pregnant Women
- Behavioral Health Precertifications
- Documentation for Offer to Counsel
- Missouri Medicaid Audit and Compliance Screening Requirements
- Missouri Medicaid Audit and Compliance Enrollment or Revalidation Process
- Provider Address Changes
- Missouri Medicaid Audit and Compliance
- Primary Care Rate Increase Program Ending
- Securing and Protection of Health Information
- Reporting Sequestration for Medicare Part C Plans
- Denture Coverage Reminders
- Hyperbaric Oxygen Therapy
- Influenza Vaccines Updates for Vaccines for Children
- Additional Services Available through the MO Tobacco Quitline
- Provider Manuals
- Behavioral Health Cyber Access
- Non-Emergency Medical Transportation
The MO HealthNet Division provides weekly tips to providers to assist them in receiving timely reimbursement for services provided. As each new tip is posted, existing ones are archived on the same site for easy reference. Please share these weekly tips with your billing staff.