EBP Setup for LA Provider Integration

Requirement

LA County requires the 837 Professional 2400-NTE and the 837 Institutional 2400-NTE claim note is populated with either the primary EBP or Service Strategy. Any applicable EBP, other than 99-Unknown, should be prioritized over a Service Strategy. Claims will reject if this segment is not present.

LA County also requests the “Emergency Indicator” on the 837 Professional in Loop 2400-SV1-09. This is not a required field for claims submission.

Resolution

Utilizing existing functionality in Cal-PM (functionality was ported to PM), the Product Custom Logic (PCL) is used to set up Evidence Based Practices, Service Strategies, and the Emergency Indicator. When setting up these fields in myAvatar , please use the same field numbers to be consistent.

LA Codes/Values

Emergency Indicator

N=No
Y=Yes

Evidence-Based Practices

01=Assertive Community Treatment
10=Multisystemic Therapy (both PEI and non-PEI)
11=Functional Family Therapy (both PEI and non-PEI)
2A=Brief Strategic Family Therapy
2B=Child-Parent Psychotherapy (CPP)
2C=Cognitive Behavioral Intervention for Trauma in Schools (CBITS)
2F=Depression Treatment Quality Improvement Intervention
2J=Group CBT for Major Depression
2K=Improving Mood-Promoting Access to Collaborative Treatment (IMPACT)
2L=Incredible Years (IY)
2M=Interpersonal Psychotherapy for Depression (IPT)
2P=Multidimensional Family Therapy
2R=Parent-Child Interaction Therapy (PCIT)
2T=Prolonged Exposure for PTSD (PE-PTSD)
2V=Strengthening Families
2W=Trauma Focused SBT (TF_CBT)
2Y=Triple P Positive Parenting Program
3B=Caring for Our Families

3D=GLBR Champs
3E=Loving Intervention for Family Enrichment (LIFE) Program
3M=ULA Ties Transition Model
4A=Aggression Replacement Training (ART)
4B=Alternative for Families/Abuse Focused CBT (AF-CBT)
4D=Crisis Oriented Recovery Services
4E=Early Detection and Intervention for the Prevention of Psychosis (EDIPP)
4K=Managing and Adapting Practice (MAP)
4N=Seeking Safety
4R=Families Over Coming Under Stress
7A=School Threat Assessment Response Team (START)
7B=Stigma and Discrimination
7C=Suicide Prevention Hotline
7D=Pacific Clinic’s Latina Youth Program
7E=Health Care Partners +60
7F=Suicide Prevention Specialist Team
7G=Older Adult Primary Care Partnership
7H=Partnership with Hospitals for aftercare
7J=Support Group for Survivors and Bereaved
7K=Training Community Partners
7L=Partnerships with Law Enforcement and First Responders
7M=Distant and On-Line Learning for Suicide Prevention
7N=School-based Targeted MH prevention and Early Intervention-Outreach & Engagement
7P=PEERS – Embracing Empowerment and Resilience Support Network
7Q=Early Screening, Identification and Mental Health Consultation
7R=Partners in Student Achievement

Service Strategies

50=Peer and/or Family Delivered Services
51=Psychoeducation
52=Family Support
53=Supportive Education
54=Delivered in Partnership with Law Enf
55=Delivered in Partnership with HC
56=Delivered in Partnership with Soc Svc
57=Delivered in Partnership with SA Svc
58=Integrated Services for MH and Aging
59=Integrated Services for MH and Dev Dis
60=Ethnic-Specific Service Strategy
61=Age-Specific Service Strategy
99=Unknown EBP / SS

 The Evidence-based Practices and Service Strategies definitions are in the old IS coding manual. See link here: http://lacdmh.lacounty.gov/hipaa/CR48.html. These codes are not in the Data Dictionary spreadsheet on the LA IBHIS technical specifications website. http://lacdmh.lacounty.gov/hipaa/IBH...tification.htm\

Client Charge Input (Site Specific Section Modeling)

Emergency Indicator

Evidence Based Practices

Service Strategies

Appointment Scheduling (Site Specific Section Modeling)

Emergency Indicator

Evidence Based Practices

Service Based Strategies

Now the new fields display on the appointment form.

CWS – Progress Notes (Site Specific Section Modeling)

Emergency Indicator

Evidence Based Practices

Service Based Strategies