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It explains how the guide helps providers understand appropriate billing and documentation expectations, while clarifying that it is not a complete catalog of Anthem policies and does not provide legal, tax, or medical advice. The document organizes topics such as certifications and licensing, correct coding using CPT/HCPCS/Revenue codes, and submission practices for claims, including required documentation and reporting timed units. 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This Resource Guide is to provide information that will better assist with appropriate and expected billing and documentation.  \nThis Resource Guide is not intended to be a complete catalog of all Anthem policies and procedures. Other policies and procedures not included in this Resource Guide may be posted on the Anthem website or published in specially targeted communications, including but not limited to bulletins and newsletters. This Resource Guide does not contain legal, tax or medical advice. Care provider partners should consult their advisors for advice on these topics.  \nApplied Behavior Analysis (ABA) Provider Resource Guide  \nTopics and resources  \nCertifications, credentialing, and licensing ..................................................................................................................................................... 3  \nCorrect coding ............................................................................................................................................................................................................................ 3  \nAdaptive Behavior Services – Category I Codes....................................................................................................................................3  \nAdaptive Behavior Assessments and Treatment – Category III Codes ............................................................................4  \nDefinitions .................................................................................................................................................................................................................................4  \nSupervision...............................................................................................................................................................................................................................6  \nClaim submission .....................................................................................................................................................................................................................6  \nCMS-1500 Field 31 ...............................................................................................................................................................................................................6  \nReporting timed units ....................................................................................................................................................................................................6  \nPlace of service (POS) ..........................................................................................................................................................................................................6  \nRecord documentation....................................................................................................................................................................................................... 7  \nTreatment plans ....................................................................................................................................................................................................................... 8  \nTele health/virtual visits ..................................................................................................................................................................................................... 8  \nNational Correct ","cbCaiaWR9LY6E5st","https://ap.wps.com/l/cbCaiaWR9LY6E5st","pdf",459847,"English","# Certifications, credentialing, and licensing\n# Correct coding\n## Adaptive Behavior Services – Category I Codes\n## Adaptive Behavior Assessments and Treatment – Category III Codes\n# Record documentation\n# Treatment plans\n# Tele health/virtual visits\n# Claim submission\n## CMS-1500 Field 31\n## Reporting timed units\n## Place of service (POS)\n# National Correct Coding Initiative (NCCI) - Medically unlikely edits (MUE)","[{\"question\":\"What is the purpose of the Anthem ABA Provider Resource Guide?\",\"answer\":\"It provides important administrative requirements, policies, and procedures to help providers understand expectations for Adaptive Behavior Treatment, especially ABA services, including billing and documentation guidance.\"},{\"question\":\"What coding systems must providers use for claim submissions?\",\"answer\":\"Providers must use industry-standard compliant codes, including CPT codes, HCPCS codes and/or Revenue codes, consistent with the services and procedures performed.\"},{\"question\":\"What should providers ensure regarding certifications, credentialing, and licensing?\",\"answer\":\"The guide describes approved provider types and instructs providers to review Anthem credentialing requirements by selecting the appropriate state for state-specific information.\"}]","Applied Behavior Analysis Provider Resource Guide - Provider Billing and Coding Requirements | PDF",1789912671]