One simple question can be used to help determine if a patient could benefit from a brief assessment or referral for a comprehensive Alcohol and Other Drug Dependence (AOD) evaluation:
In the next issue of the newsletter, we’ll provide more information on validated AOD brief assessment and screening tools.
The following ICD 9 codes can be used to identify patients with substance use disorders.
If you have diagnosed your patient with AOD dependence, it is important to either have timely follow up with that patient yourself or refer them for AOD services. This follow up helps to assure that the patient fully initiates and engages in treatment.
To refer a Unity member for additional AOD services, contact one of the following resources based on the location of the member’s Primary Care Physician (PCP):
There may be instances when a patient’s alcohol or drug use is simply discussed during a visit and may not lead to a diagnosis or when the patient is ambiguous about a referral to an addictions program. In these instances, it may be more appropriate to use one of the following V-codes rather than the ICD codes listed prior.
The Healthcare Effectiveness Data and Information Set (HEDIS®) has established measures for the Initiation and Engagement of Alcohol and other Drug Dependence Treatment (AOD).
If your patient is inpatient with a new (new patient is defined as someone who did not have an encounter with an AOD dependence diagnosis in the past 60 days) diagnosis of AOD dependence, then they are considered to have initiated treatment. If your patient is given a new AOD dependence diagnosis during an outpatient visit, they need to have an additional outpatient visit, partial hospitalization, or admission with an AOD dependence code within 14 days to be compliant with the initiation measure.
To be engaged in treatment, your patient needs to have two or more additional inpatient admissions, outpatient visits, or partial hospitalizations with an AOD dependence diagnosis. This must have occurred within 30 days after the date of initiation (the admission or first outpatient visit.) HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
