Eating Disorder Codes for Insurance Billing

Insurance covers eating disorders just like substance abuse depression and anxiety

• We are experts at knowing the right codes for the right diagnosis and carrier.
• We have a very good pulse on the national averages of reimbursement and will fight for the correct pricing
• We are experts in the complexities of insurance billing for eating disorders and mental health.

Most policies will cover eating disorders because it falls under behavioral health coverage

• Parity law enforces the coverage of eating disorders.
• We check all benefits before admission to determine eligibility.
• Give peace of mind to your patients of an idea of what to expect $$$ wise.

Axis can speak to families directly regarding eating disorders and their insurance

• We are licensed professionals that actually can advise and enroll patients into the proper health plans.
• We can walk patients through the possibility of reimbursement and set expectations.
• You have direct access through our online software to see where every claim is processing at any given time.

Out of network benefits can help cover the cost 30%-50% of cash pay clients

• Out of network insurance pays above the national average.
• No extra processes on your part, we operate within the business operations you have set up.
• Increase revenue with no extra work.

Do you ask potential admissions if they are using insurance?

• Add insurance reimbursement to your admissions tool belt.
• Know the right questions to ask – (we do that).
• Have confidence in getting claims processed and paid.

How to do ROP and IOP/PHP claims from the facility and/or treating therapist

• We make sure NPI’s are on file and distinguished before submitting claims.
• We make sure you are credentialed as in or out of network depending on your contracts.
• Negotiate with third party pricing companies pre-billing for ease of processing.

Eating Disorder FCode Example for Insurance Billing

• ICD-10-CM Codes 
• › F01-F99 Mental, Behavioral and Neurodevelopmental disorders 
• › F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors 
• › F50- Eating disorders 
• › 2021 ICD-10-CM Diagnosis Code F50.9

 2021 ICD-10-CM Diagnosis Code F50.9 

Eating disorder, unspecified

2020-2021 Billable/Specific Code

• F50.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• The 2021 edition of ICD-10-CM F50.9 became effective on October 1, 2020.
• This is the American ICD-10-CM version of F50.9 – other international versions of ICD-10 F50.9 may differ.

Applicable To

• Atypical anorexia nervosa
• Atypical bulimia nervosa
• Feeding or eating disorder, unspecified
• Other specified feeding disorder

The following code(s) above F50.9 contain annotation back-references that may be applicable to F50.9:

• F01-F99  Mental, Behavioral and Neurodevelopmental disorders
• F50  Eating disorders

Approximate Synonyms

• Eating disorder

Clinical Information

• A broad group of psychological disorders with abnormal eating behaviors leading to physiological effects from overeating or insufficient food intake.
• A group of disorders characterized by physiological and psychological disturbances in appetite or food intake.
• Eating disorders are serious behavior problems. They include
  • anorexia nervosa, in which you become too thin, but you don’t eat enough because you think you are fat
  • bulimia nervosa, involving periods of overeating followed by purging, sometimes through self-induced vomiting or using laxatives
  • binge-eating, which is out-of-control eating
• women are more likely than men to have eating disorders. They usually start in the teenage years and often occur along with depression, anxiety disorders and substance abuse. Eating disorders can cause heart and kidney problems and even death. Getting help early is important. Treatment involves monitoring, mental health therapy, nutritional counseling and sometimes medicines.
• Group of disorders characterized by physiological and psychological disturbances in eating behavior, appetite or food intake.

ICD-10-CM F50.9 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):

• 887 Other mental disorder diagnoses

Convert F50.9 to ICD-9-CM

Code annotations containing back-references to F50.9:

• Type 1 Excludes: R13.0

Diagnosis Index entries containing back-references to F50.9:

• Anorexia R63.0
  • nervosa F50.00
    • atypical F50.9
• Aphagia R13.0
  • psychogenic F50.9
• Bulimia (nervosa) F50.2
  • atypical F50.9
  • normal weight F50.9
• Disorder (of) – see also Disease
  • eating (adult) (psychogenic) F50.9
  • feeding (infant or child) R63.3 – see also Disorder, eating
    • or eating disorder F50.9
    • specified NEC F50.9
  • psychogenic NOS F45.9 – see also condition
    • appetite F50.9

Reimbursement claims with a date of service on or after October 1, 2020 require the use of ICD-10-CM codes.

Eating Disorder Billing Codes for Insurance

Facility/Program Universal Services List	Preferred Codes for UB‐04 Billing	Preferred Codes for CMS 1500 Billing
USL #	Standard Services	Revenue Code	Type of Bill Code	CPT/HCPCS Codes	HCPCS Modifier	CPT/ HCPCS Codes	HCPCS Modifier
	Hospitalization
1.1	Hospitalization, Psychiatric	0114, 0124, 0134, 0144, 0154				N/A ‐ Bill inpatient services on UB‐04 form
1.2	Hospitalization, Substance Use Disorders, Rehabilitation Treatment	0118, 0128, 0138, 0148, 0158				N/A ‐ Bill inpatient services on UB‐04 form
1.3	Hospitalization, Substance‐Induced Disorders	0118, 0128, 0138, 0148, 0158				N/A ‐ Bill inpatient services on UB‐04 form
1.4	Hospitalization, Substance Use Disorders, Detoxification	0116, 0126, 0136, 0146, 0156				N/A ‐ Bill inpatient services on UB‐04 form
1.5	Hospitalization, Eating Disorders	0114, 0124, 0134, 0144, 0154				N/A ‐ Bill inpatient services on UB‐04 form
1.6	Hospitalization, 23 Hr Bed, Psychiatric	0762				N/A ‐ Bill inpatient services on UB‐04 form
1.7	Hospitalization, 23 Hr Bed, Substance Use Disorders, Rehabilitation Treatment	0762				N/A ‐ Bill inpatient services on UB‐04 form
	Residential Treatment
2.1	Residential Treatment, Psychiatric	1001		H0017 or H0018		H0017 or H0018
2.2	Residential Treatment, Substance Use Disorders, Rehabilitation Treatment	1002		H0011		H0011
2.3	Residential Treatment, Eating Disorders	1001		H0017 or H0018		H0017 or H0018
	Partial Hospitalization
3.1	Partial Hospitalization, Psychiatric	0912 or 0913		H0035		H0035
3.2	Partial Hospitalization, Substance Use Disorders, Rehabilitation Treatment	0912 or 0913		H0035		H0035
3.3	Partial Hospitalization, Eating Disorders	0912 or 0913		H0035		H0035
	Intensive Outpatient Treatment
4.1	Intensive Outpatient, Psychiatric	0905		S9480		S9480
4.2	Intensive Outpatient, Substance Use Disorders, Rehabilitation Treatment	0906		H0015		H0015
4.3	Intensive Outpatient, Eating Disorders	0905		S9480		S9480
Facility/Program Universal Services List	Preferred Codes for UB‐04 Billing	Preferred Codes for CMS 1500 Billing
	Outpatient
5.1	Outpatient Therapy Services, Psychiatric/Substance Use Disorders	0914 0915 0916		Use appropriate CPTs		Use appropriate CPTs
5.2	Outpatient Aftercare (“Bridge Appointment”) Program	0513
5.3	Applied Behavior Analysis (Autism)			Applicable CPT codes for ABA services		Applicable CPT codes for ABA services
5.4	Electroconvulsive Therapy (ECT)	0901		90870		90870
5.5	ECT Anesthesia	0901		00104		00104
5.6	Ambulatory, Substance Use Disorders, Detoxification	0944 or 0945		H0014		H0014
5.7	Ambulatory, Substance Use Disorders, Buprenorphine Maintenance.	0944		H0001 H0014	HG HG	H0001 H0014	HG HG
5.8	Methadone Maintenance	0944 or 0529		H0020		H0020
5.9	Crisis Stabilization	0900 or 0914		S9485		S9485
5.10	Emergency Room	045x		99281 ‐ 99285		99281 ‐ 99285
5.11	Injections			96372		96372
5.12	Home Health Therapy Services	058x		Applicable CPT codes		Applicable CPT codes
5.13	Nursing Home/Domiciliary or Rest Home Visit	N/A		Applicable CPT codes		Applicable CPT codes
	Ancillary Services
6.1	Telehealth Administrative Services	078x		Q3014		Q3014
6.2	Non‐Emergency Transportation			S0209 S0215 A0100		S0209 S0215 A0100
6.3	Emergency Transportation / Ambulance Service	054x		A0021 A0999		A0021 A0999
6.4	Interpreter Services			T1013		T1013
6.5	Laboratory services	030x		H0003 H0048		H0003 H0048