ED Coding and Reimbursement Alert

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Let DAST Guide Your Counseling Claims

Published on Fri Jan 26, 2007

Use this list to ensure physician conducts a -structured screening-

When your ED physician conducts an alcohol/ substance abuse screening in 2008, you-ll have two new codes to choose from to account for the service.

With the new counseling codes 99408 and 99409, "doctors will now be able to assess their patients- drug and alcohol use -- as they already do for diabetes and obesity -- and work to prevent, reduce and treat those with substance abuse disorders," said White House Office of National Drug Control Policy (ONDCP) deputy director Bertha Madras in a press release.

What to document: You can't bill 99408 (Alcohol and/or substance [other than tobacco] abuse structured screening [e.g., AUDIT, DAST], and brief intervention [SBI] services; 15 to 30 minutes) or 99409 ( - greater than 30 minutes) unless your physician documents a structured screening session, say experts.

This screening should include specific questionnaires, either in writing or verbally. The physician may also take part in a brief intervention that goes beyond simply advising the patient to stop abusing substances.

In order to code 99408 or 99409 properly, you-ll need to show that the physician performed a "structured screening" to address the patient's alcohol or substance abuse issues.

Template: To ensure that the physician conducts a structured screening, the White House Office of National Drug Control Policy (ONDCP) recommends that physicians use a tool like the Drug Abuse Screening Test (DAST), which includes questions such as:

Can you get through the week without using drugs?

Are you always able to stop using drugs when you want to?

Do you ever feel bad or guilty about your drug use?

Have you neglected your family because of your drug use?

Have you been in trouble at work because of your-drug use?

Have you engaged in illegal activities to obtain drugs?

Have you ever experienced withdrawal symptoms (felt sick) when you stopped-taking drugs?

Have you had medical -problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?