Need Assistance?
Would you like more assistance regarding Health IT Enabled QI strategies or support in using any of the included resource sets?

  Request Support

 

Upcoming Events

Overview

Validating data from Health IT systems is the cornerstone of effective Health IT Enabled QI. Ensuring that Health IT-generated reports and data reflect an accurate picture of the care and outcomes of your population ensures that data is actionable for quality improvement, monitoring as well as many other purposes. This validation must be ongoing as system , provider, workflow, and other changes, can all impact accuracy of data. This section provides worksheets, guides, and tips for validating data.

Data Accuracy Resources
Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide
HITEQ Center
/ Categories: Priority Topics, Ending the HIV Epidemic, HIV, PrEP

Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Other HIV Prevention Strategies: Billing and Coding Guide

Developed by NASTAD, updated in 2023

Health departments and other medical providers are billing Medicaid, Medicare, and private insurers for services related to HIV prevention. The counseling services needed for the treatment and discussion of lab tests are intensive. This guide describes the procedure and diagnosis codes that are accepted by public and private insurance, along with specific requirements for some Current Procedural Terminology (CPT®) billing codes. It also describes some of the challenges in obtaining reimbursement for testing, counseling, linkage to care, and adherence services.

The goal of this guide is to provide up-to-date information and best practices for coding, billing, and denial resolution for PrEP and PEP services. Health department staff are encouraged to share this resource with grantees, community partners, and other health care providers billing for HIV prevention services.

Print
16757
Tags: GuideBillingcodingHIVPrEPEnding the HIV EpidemicHIV screeningHIV prevention

Resource Links

Related Resources

Acknowledgements

This resource collection was compiled by the HITEQ Center staff with guidance from HITEQ Advisory Committee members and collaborators of the HITEQ Center.