Billing Codes
Case Management Process
Document Upload Locations
Should I or shouldn't I?
Process Details
100

This code is used for a 60 minute therapy session

99837

100

Initial phone call or in person data collection interview

Intake

100

This is where you would scan an intake packet from a chart created prior to 11/12/2024

Vital Documents

100

You have taken the State car to bring a client home from the clinic and they ask you to stop at Target so they can buy a gift for their friend.  What do you do?

Attempt to redirect the client and explain the purpose of the transport, potentially offer additional options for transport.

100

When scheduling an out of office notification - after notifying Clinic Site Supervisor and Altres, your away status should be set as what in Teams for the meeting invite?

Free

200

This code is used for a comprehensive psychiatric evaluation.

90792

200

This is where a case manager keeps their appointments.

Avatar Scheduling Calendar

200

This is where you would upload a birth certificate

Historical Legal

200

Client asks you to take them to TSA because they are moving off island and want to get precheck.  What should you do?

Explain the purpose of the State car and that TSA precheck is not required to board a plane.

200

A case manager should follow up with a client how soon after receiving a referral, a phone call, or a request from a provider?

By the next business day.

300

These letters are used as a modifier to most codes to indicate a telehealth session

GT

300

A case manager follows up this frequently when a client scores Level 3 on the LOCUS or CALOCUS evaluation

Weekly

300

This is where you would upload a signed Notice of Privacy Practices

Consent and Releases

300

This is the next step if a therapist asks you to schedule an extension on therapy.

Ask if the extension was approved

300

Two things a case manager should inform a supervisor about after opening a new Avatar episode for a client

A diagnosis is needed

Insurance information

400

This code is used for billable case management services face to face.

FH2015

400
This is where you find the data from a "QR code"

Sharepoint QR Master Log

400

There is where you would upload records from a recent Molokini admission.

Historical Medical

400

Client calls in requesting to be seen; we do not have them in Avatar, they are Kaiser.  You check the referral log, they have never called in and Kaiser never sent a preauth.  You check Kaiser and notice an authorization from September 2024, it is January 2025.  You create the Avatar episode for what date?

January 2025

400
A client calls in and you share the hours of the clinic.  What hours do you share.

Clinic is open from 9am - 6pm.

500

Kaiser has been authorizing this very short psychiatry follow up code, which is anywhere between 15 and 20 minutes.

99213

500

You should ask the psychiatrist what question if they request a follow up appointment with a client in one month.

Would you like for them to be scheduled monthly ongoing or just one follow up appointment?

500

There is where you would upload an unsigned Informed Consent to Evaluate

You don't upload an unsigned document

500

You notice a Kaiser authorization is about to expire; you know where the reauthorization form lives.  What do you do next?

Ask the therapist or psychiatrist if treatment needs to be extended; find the licensed professional involved with the case to complete the form.

500

A client is discharged on 12/31/24.  You have until when to ensure the chart is correctly and fully uploaded.

1/13/25