DMC-ODS Billing Manual Changes
New Content
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5.2.6 Beneficiary Gender- Now the beneficiary’s gender needs to be reported on the claim, but will not be verified by SD/MC as of 7-1-2023.
- 5.2.17 Under DMC-ODS, counties have the option of providing medically monitored and/or managed intensive residential treatment services under ASAM Levels of Care
- 3.7 and 4.0. These services are classified as institutional claims and must be submitted using an 837I transaction file.
- New Modifier Table 3
- HV Modifier was Removed
- GQ Modifier added
- Via asynchronous telecommunication system
- HF Modifier added
- Identifies when Contingency Management Services was provided as part of a Substance Use Disorder Program
Layout changes
| Description/Notes | |
|---|---|
| 3.1.3 | Monthly MEDS Extract file (MMEF) split from Eligibility Review section. |
| 3.1.4 | MEDS and MEDSLITE now its own section |
| 5.2.X | Now contains Information for Approving and Denying Claims. |
| 5.2.34 | Link to document BHIN 21-075 now clarifies coverage of voluntary inpatient detoxification through the Medi-Cal Fee-For-Service program. |
Assessment codes
- Service Table 2 SUD Crisis Intervention Codes
- H0007 Add Allowable Discipline AOD
- Service Table 4 Mobile Crisis Codes
- H2011 Moved to this section and is now Mobile Crisis
Appendix 1 Taxonomy Codes
| Taxonomy Code | Notes |
|---|---|
| Discipline- Marriage and Family Therapist(MFT) or Licensed Professional |
|
| Discipline- Registered Nurse(RN) |
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| Discipline- Licensed Clinical Social Worker |
|
Appendix 3: DMC ODS Procedure Codes
- Added H0025- Behavioral health prevention education services, 15 minutes
- Added H0038- Self-help/peer services, 15 minutes
- Added H2011- Mobile crisis