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Co-occurring Diagnosis

Jill 3 years ago in Codes/Rates/Diagnosis Modules updated 3 years ago 2

Good afternoon!  This may be a basic question, but at the risk of sounding "un-informed" I'm going to ask it anyway :)


I was recently made aware that a modifier can be used on claims to indicate when a client has a co-occurring diagnosis.  For example, a chemical dependency diagnosis along with a mental health diagnosis.  I was told that this could potentially result in a higher payments.  Do you know if this is the case and what that modifier is?


If you include it as part of your attestation when you get certified for State of MN as a provider, and you can show that you meet certain criteria as a provider, there is potentially an enhanced rate for CD providers via the consolidated chemical dependency treatment fund.  I don't know how this would be impacted if you aren't a Rule 31 provider. For information, if you can find them online, there are a couple of bulletins put out by DHS that clarify the rules around the enhanced rates: The first bulletin was 14-51-01 dated July 10, 2014 and the second bulletin with further clarifications was 15-51-01 dated January 7, 2015 and then there is a CCDTF e-memo #15-15 dated June 2, 2015 which all provide clarifications to the rules and to the first bulletin about who can provide what services and how.  I would contact Provider Relations to get more details on whether your agency qualifies or not.

Thank you so much for the info!  I appreciate your response.