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BCN Behavioral Health Inpatient Concurrent Review Form Review date Diagnosis Provider name Therapist name Member name Provider NPI Member ID DSM-IV code Telephone Provider tax ID Reviewer name Date s of service PCP name Date PCP communication occurred PCP release Offered / signed Offered / declined Date Problems symptoms need for continued care Presenting problem include precipitant to admission Current symptoms include list of specific symptoms .

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How to fill out the Cigna Iop Form online

Filling out the Cigna Iop Form online is a straightforward process that ensures the necessary information is collected effectively. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to successfully complete the Cigna Iop Form.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
  2. Review the form's structure, which includes sections for the review date, diagnosis, and provider details. Fill in your information accurately, ensuring all fields are completed as required.
  3. Provide member information by including the member name, member ID number, and therapist name. Double-check the entries for accuracy.
  4. In the section for the presenting problem, describe the issues that led to the admission, mentioning any specific symptoms experienced in the last 24 hours.
  5. Complete the justification for continued stay by explaining why the patient requires ongoing care at this level. This should be detailed and specific.
  6. Indicate any barriers to discharge by circling whether each barrier is an issue or not, and document plans to address these barriers. Include categories such as housing, safety plans, job jeopardy, and transportation.
  7. Set forth the goals of treatment including a list of active interventions aimed at addressing the admission reason, current symptoms, and problems presented.
  8. Finish by outlining the discharge information, including anticipated discharge date and follow-up appointments.
  9. Once all sections are filled in, review the form for any errors or omissions. Save changes, and then choose to download, print, or share the completed form as necessary.

Complete your documentation online for a smoother process.

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Commonly used IOP CPT codes: 90853: Group psychotherapy (other than a multiple-family group) 90846: Family psychotherapy (without the patient present) 90847: Family psychotherapy (conjoint psychotherapy) (with the patient present)

Common Intensive Outpatient Program Billing Codes Psychotherapy Codes - CPT codes 90832-90838: These codes cover individual psychotherapy sessions of varying durations, including initial assessments and subsequent sessions.

If you are unable to use electronic prior authorization, you can call us at 800.88Cigna (882.4462) to submit a prior authorization request. For Inpatient/partial hospitalization programs, call 800.926.2273. Submit the appropriate form for outpatient care precertifications. Visit the form center.

HCPCS Code for Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education H0015.

For mental health disorders, the commonly used IOP billing code is S9480. This per diem outpatient code is used when billing for services related to depression, anxiety, bipolar disorder, and eating disorders.

2024 HCPCS Code S9480 : Intensive outpatient psychiatric services, per diem.

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