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:


Diagnosis Index entries containing back-references to 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 BillingPreferred Codes for CMS 1500 Billing
USL #Standard ServicesRevenue CodeType of Bill CodeCPT/HCPCS CodesHCPCS ModifierCPT/ HCPCS CodesHCPCS Modifier
Hospitalization
1.1Hospitalization, Psychiatric0114, 0124,
0134, 0144,
0154
N/A ‐ Bill inpatient services on UB‐04 form
1.2Hospitalization, Substance Use Disorders, Rehabilitation Treatment0118, 0128,
0138, 0148,
0158
N/A ‐ Bill inpatient services on UB‐04 form
1.3Hospitalization, Substance‐Induced Disorders0118, 0128,
0138, 0148,
0158
N/A ‐ Bill inpatient services on UB‐04 form
1.4Hospitalization, Substance Use Disorders, Detoxification0116, 0126,
0136, 0146,
0156
N/A ‐ Bill inpatient services on UB‐04 form
1.5Hospitalization, Eating Disorders0114, 0124,
0134, 0144,
0154
N/A ‐ Bill inpatient services on UB‐04 form
1.6Hospitalization, 23 Hr Bed, Psychiatric0762N/A ‐ Bill inpatient services on UB‐04 form
1.7Hospitalization, 23 Hr Bed, Substance Use Disorders, Rehabilitation Treatment0762N/A ‐ Bill inpatient services on UB‐04 form
Residential Treatment
2.1Residential Treatment, Psychiatric1001H0017 or H0018H0017 or H0018
2.2Residential Treatment, Substance Use Disorders, Rehabilitation Treatment1002H0011H0011
2.3Residential Treatment, Eating Disorders1001H0017 or H0018H0017 or H0018
Partial Hospitalization
3.1Partial Hospitalization, Psychiatric0912 or
0913
H0035H0035
3.2Partial Hospitalization, Substance Use Disorders,
Rehabilitation Treatment
0912 or
0913
H0035H0035
3.3Partial Hospitalization, Eating Disorders0912 or
0913
H0035H0035
Intensive Outpatient Treatment
4.1Intensive Outpatient, Psychiatric0905S9480S9480
4.2Intensive Outpatient, Substance Use Disorders, Rehabilitation Treatment0906H0015H0015
4.3Intensive Outpatient, Eating Disorders0905S9480S9480
Facility/Program
Universal Services List
Preferred Codes for UB‐04 BillingPreferred Codes for CMS 1500 Billing
Outpatient
5.1Outpatient Therapy Services, Psychiatric/Substance Use Disorders0914
0915
0916
Use appropriate CPTsUse appropriate CPTs
5.2Outpatient Aftercare (“Bridge Appointment”)
Program
0513
5.3Applied Behavior Analysis (Autism)Applicable CPT codes
for ABA services
Applicable CPT codes
for ABA services
5.4Electroconvulsive Therapy (ECT)09019087090870
5.5ECT Anesthesia09010010400104
5.6Ambulatory, Substance Use Disorders,
Detoxification
0944 or
0945
H0014H0014
5.7Ambulatory, Substance Use Disorders, Buprenorphine Maintenance.0944H0001 H0014HG HGH0001 H0014HG HG
5.8Methadone Maintenance0944 or 0529H0020H0020
5.9Crisis Stabilization0900 or
0914
S9485S9485
5.10Emergency Room045x99281 ‐ 9928599281 ‐ 99285
5.11Injections9637296372
5.12Home Health Therapy Services058xApplicable CPT codesApplicable CPT codes
5.13Nursing Home/Domiciliary or Rest Home VisitN/AApplicable CPT codesApplicable CPT codes
Ancillary Services
6.1Telehealth Administrative Services078xQ3014Q3014
6.2Non‐Emergency TransportationS0209
S0215 A0100
S0209
S0215 A0100
6.3Emergency Transportation / Ambulance Service054xA0021
A0999
A0021
A0999
6.4Interpreter ServicesT1013T1013
6.5Laboratory services030xH0003
H0048
H0003
H0048

2 thoughts on “Eating Disorder Codes for Insurance Billing

  1. I’m trying to file a Single Case Agreement for IOP for anorexia nervosa with my aetna insurance. They said I need to provide them with the name of the provider, the address, my diagnosis, and the procedure code. What are they actually asking for there? I know my diagnosis has a code, is that what they want? or is there a special facility procedure code that they want? I’m confused.

    1. Hi Heather,

      Great questions.

      The code for Aetna IOP is S9480.

      The rest of the information you would need to get from your provider.

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