Requesting SUD clients

This policy deals with working with SUD clients and will help prevent client mismatch during booking, denied insurance claims, and adherence to ethical guidelines.  

Who can work with SUD clients?

To work with SUD clients, you need to meet ONE of the following criteria:

• Licensed LAC
• LAC in training w/ supervision from a LAC
• 6+ hours of training in addictions

Clinicians who meet one of these criteria CAN have addiction/alcohol use/substance abuse on their profile, and clients who identify addictions as their primary reason(s) for seeking treatment will be booked with these clinicians.  

Clinicians who do not meet the above criteria

Clients that book and describe a NON-SUD/Addiction as their primary reason for seeking treatment however mention addictions/SUD as a problem and you determine that they should be diagnosed with a SUD dx need to be handled accordingly:

• The SUD diagnosis CAN NOT be in the primary diagnosis position, it needs to be placed in the second position - with all insurance payers.
• Referrals to other facilities/groups/providers for the client’s SUD need to be provided and documented.
  • Situation: the client describes depression as their primary problem but mentions alcohol abuse as another problem area - you would treat the client for their depression in the primary dx but then document how you referred out to other facilities/groups/providers for alcohol addiction.

CCHA-Medicaid Special Requirements

Note that with CCHA (Medicaid) 90791, 90837/34/32 cannot be billed with a SUD dx in the primary position.  These services codes are mental health services code and therefore a mental health dx needs to be in the primary.  A SUD dx can be placed in the secondary position.