Non-Billable- Case Management

Non-Billable- Case ManagementService Code Approved Use Summary CODE # 800 CODE NAME Non-Bill Case Management 800 DEFINITIONA direct case management (CM) service (Service Code 50) provided to a client that is not eligible for reimbursement for reasons including but not limited to: Providing a client with academic educational services, work training activities, social activities, grooming or personal care assistance, payee related services and transportation time when no billable service has occurred. (Formerly Service Code 60)  Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 50 SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office* E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face* F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Anasazi User Manual, Effective 07 01 2012 Non-Billable- Medication/Med SupportService Code Approved Use Summary CODE # 801 CODE NAME Non-Bill Med/Support Svcs 801DEFINITIONA direct medication or med support service provided to a client that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Codes 11, 19, 20, 21, 22, 23 SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office* E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face* F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL RN PHARMD LVN Nurse Practitioner MD Trainee MD DO LPT Physician AsstAnasazi User Manual, Effective 07 01 2012 Non-Billable- Mental Health ServiceService Code Approved Use Summary CODE # 802 CODE NAME Non-Bill Mental Health Svc 802DEFINITIONA direct mental health service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Codes 9, 10, 12, 13, 14, 15, 16, 30-40 SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office* E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face* F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Anasazi User Manual, Effective 07 01 2012 Non-Billable- Crisis Intervention ServiceService Code Approved Use Summary CODE # 803 CODE NAME Non-Bill Crisis Intervent 803DEFINITIONA direct crisis intervention service that is not eligible for reimbursement for reasons including but not limited to: Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 70 SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office* E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face* F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled J – Client Job Site 2 – Unscheduled/Walk-in* K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Anasazi User Manual, Effective 07 01 2012 Non-Billable- Full Day Intensive TxService Code Approved Use Summary CODE # 804 CODE NAME Non-Bill Full Day Intensive Tx 804DEFINITIONA direct full day intensive treatment service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 95SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Anasazi User Manual, Effective 07 01 2012 Non-Billable- Half Day Intensive TreatmentService Code Approved Use Summary CODE # 805 CODE NAME Non-Bill Half Day Intensive Tx 805DEFINITIONA direct half day intensive treatment service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 95SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Full Day Rehab TxAnasazi User Manual, Effective 07 01 2012 Service Code Approved Use Summary CODE # 806 CODE NAME Non-Bill Full Day Rehab Tx 806DEFINITIONA direct full day rehab treatment service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 95SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Half Day Rehab TreatmentAnasazi User Manual, Effective 07 01 2012 Service Code Approved Use Summary CODE # 807 CODE NAME Non-Bill Half Day Rehab Tx 807DEFINITIONA direct half day rehab treatment service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 95SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Therapeutic Behavioral Services Service Code Approved Use Summary CODE # 808 CODE NAME Non-Bill TBS 808Anasazi User Manual, Effective 07 01 2012 DEFINITIONA direct TBS service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 46, 47, 48, 49SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Inpatient Hospital Bed DayService Code Approved Use Summary CODE # 809 CODE NAME Non-Bill IP Hosp Bed Day 809DEFINITIONAnasazi User Manual, Effective 07 01 2012 A direct bed day service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 906 & 907SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Psychiatric Health Facility (PHF) Bed DayService Code Approved Use Summary CODE # 810 CODE NAME Non-Bill PHF Bed Day 810DEFINITIONA direct PHF bed day service that is not eligible for reimbursement for reasons including but not limited to:Anasazi User Manual, Effective 07 01 2012  Service provided without a valid client plan  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 908SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Crisis Residential Bed DayService Code Approved Use Summary CODE # 811 CODE NAME Non-Bill Crisis Res BedDay 811DEFINITIONA direct crisis residential bed day service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of serviceAnasazi User Manual, Effective 07 01 2012  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 909SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Adult Residential Bed Day (Non-Crisis)Service Code Approved Use Summary CODE # 812 CODE NAME Non-Bill Adult Res Bed Day 812DEFINITIONA direct adult residential bed day service that is not eligible for reimbursement for reasons including but not limited to: Service provided without a valid client plan  Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable Anasazi User Manual, Effective 07 01 2012 service code for units of service tracking (cost reporting) Service code that is re-entered for Service Code 910SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Non-Billable- Crisis StabilizationService Code Approved Use Summary CODE # 813 CODE NAME Non-Bill Crisis Stabilizat 813DEFINITIONA direct crisis stabilization service that is not eligible for reimbursement for reasons including but not limited to: Service is not documented within 14-days of the date of service  Required signature(s) are missing from documentation  Service that is disallowed/voided and must to be re-entered into Anasazi with the non-billable service code for units of service tracking (cost reporting)Anasazi User Manual, Effective 07 01 2012  Recording non-billable service time beyond the allowable Medi-Cal eligible time of 20 hours per 24 hour period Service code that is re-entered for Service Code 90 & 91SERVICE INDICATORS - TABLE VALUES Person Contacted: Place of Service: Contact Type: B – Client with Family A – Office E - Telehealth C – Client* C – Correctional Facility F – Face-to-Face F – Family/Legal Guardian D – Inpatient-Full Scale Hosp/SNF** T – Telephone O – Other E – Homeless Emergency Shelter V – TTY F – Faith Based (church) G – Health Care – Primary Care Appointment Types: H – Home 1 – Scheduled* J – Client Job Site 2 – Unscheduled/Walk-in K – IP Free Standing Hosp/IMD/SH** 3 – Cancelled by Client L – Crisis Residential 4 – Cancelled by Program O – Other Community Location or Field- 5 – No Show Unspecified R – Residential Care-Children S – School** V – Residential Care-Adult * Defaults **Must also select Outside Facility from list AUTHORIZED CREDENTIAL ALL, excluding ADMIN Anasazi User Manual, Effective 07 01 2012

Non-Billable- Case Management

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