Value Code 24 Room and Board Billing MN State

Jen 4 years ago in Codes/Rates/Diagnosis Modules updated by SEHowes 3 years ago 4


We are having claims deny using the Value Code 24 (99920) that we were first instructed to use for SUD Room and Board claims back in 2019.  All claims have paid up until now, all are now denying as a non covered charge.  I have spoke with the provider help desk and they do not see the code we are using on the list.  They also said there have been no updates to the list since it came out in 2019.  I do have the code that they are saying we should be using and will be updating our system and I have set up a case with the state to review.  

I wanted to know anyone else is having this same issue?  We were thinking that it may have something to do with direct access starting 10/01/2020,

Thank you!  

my Value codes that we use for SUD Room and Board are 24/99102 --I don't even see a 99920 on the list we have I have included a snip of the 1002 rev code 

1002 Room and Board (Same Location as Tx) Adolescent 99921

 1002 Room and Board (Same Location as Tx)Adolescent/Client with Child 99216

1002 Room and Board (Same Location as Tx)Adolescent/Client with Child/MedicalSvs 92165

 1002 Room and Board (Same Location as Tx)Adolescent/MedicalSvs 99215 

1002 Room and Board (Same Location as Tx)/Client with Child 99926 

1002 Room and Board (Same Location as Tx) 99102

 1002 Room and Board (Same Location as Tx)Client with Child/MedicalSvs 99256 

1002 Room and Board (Same Location as Tx)MedicalSvs 99925 

Where have you been putting the Value Code 24 in Procentive? We have been asking where this needs to be entered since Direct Access started and we haven't had an answer. I wasn't aware that organizations are already using this!

The codes needed to be able to bill the treatment lines have not been entered yet that I am aware of.  I just asked about it again this morning,  The codes above are for the room and board that we were instructed to use.  In order for the claims to have the value24 code it needs to be entered at the code level.  Below is a screenshot of where we enter the information.  It may be different for other facilities but I am not aware of any other way.

Has there been any update regarding the value code for TX lines, vs the R&B line?  A reminder was sent out today from DHS regarding the use of the value code 24 for both the TX service as well as the R&B.  When I checked this morning there still weren't any value codes for tx services in the Code module.