Practice Support

How To's and Practice Resources


Information and resources regarding the changes to psychiatry codes in  the 2013 edition of the Current Procedural Terminology manual of the American Medical Association.  The coding changes will be effective on January 1, 2013.  (Resources provided by the American Psychiatric Association.)  [CPT Psychiatry Code Changes]

Transition to ICD-10

On July 6, 2015, the American Medical Association and Centers for Medicare and Medicaid Services (CMS) jointly announced that agreement has been reached on important elements of a “grace period” for the October 1, 2015, implementation of the ICD-10 diagnosis code set. In new guidance, CMS announced:

  • For a one year period starting October 1, Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes.  In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes.  This policy will be followed by Medicare Administrative Contractors and Recovery Audit Contractors.
  • To avoid potential problems with mid-year coding changes in CMS quality programs (PQRS, VBM and MU) for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores (i.e., for PQRS, VBM, or Meaningful Use). CMS will continue to monitor implementation and adjust the duration if needed.
  • CMS will establish an ICD-10 Ombudsman to help receive and triage physician and provider problems that need to be resolved during the transition.
  • CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.

See these documents and websites for more information:

AMA ICD-10 Transition Resources

ICD-10 FAQ from CMS

Road to 10: The Small Physician's Practice Route to ICD-10

ICD-10 Clinical Concepts Series: Family Practice

American College of Physicians: ICD-10 Tips

See a list of commonly used addiction treatment related ICD-10 codes.

Substance Abuse Confidentiality Regulations

Applying the Substance Abuse Confidentiality Regulations 42 CFR Part 2 (FAQs)

How to Prepare for a DEA Office Inspection

ASAM members who have a Drug Enforcement Administration (DEA) registration to prescribe buprenorphine/naloxone or buprenorphine setting may be inspected by the Drug Enforcement Agency (DEA). The DEA is authorized, per the Controlled Substances Act, to inspect any DATA-waivered physicians.

ASAM members who have a Drug Enforcement Administration (DEA) registration to prescribe buprenorphine/naloxone or buprenorphine setting may be inspected by the Drug Enforcement Agency (DEA). The DEA is authorized, per the Controlled Substances Act, to inspect any DATA-waivered physicians.

How to Comply with a DEA Audit/Inspection

  • Doctor has valid “X” waiver (current DEA registration) that denotes he/she is waivered to prescribe for 30 or 100 patients. You must be ASAM-, ABPN-, or AOAAM- certified or have taken an in-person or web-based course on prescribing buprenorphine to be waivered.
  • Doctor adheres to patient prescribing limit, ie, if waivered for less than 1 year, may prescribe to 30 patients; if waivered for more than 1 year, may prescribe to 100 patients (if they have already notified CSAT of their intent to do so).
  • Doctor maintains proper records of quantities prescribed and dispensed from office. Dispensing is defined as: dispensing buprenorphine/naloxone and/or buprenorphine from a purchased stock bottle into a pill bottle that is properly labeled (DEA requires that label includes: date, patient name, name of medication, dose strength of medication, number of dispensed pills, refills, directions on how to take the medication, and expiration date of medication).
  • Stock bottles of buprenorphine/naloxone 2mg and/or 8mg pills must be kept in a secure safe place, e.g, double locked medicine cabinet, safe or locker.
  • Doctor maintains a chart (paper or electronic) on all patients receiving buprenorphine/naloxone and/or buprenorphine.
  • Doctor has access to a network of behavioral health professionals.
  • Doctor’s prescription pad has standard and “X” DEA registration number printed or written onto his/her prescription pad for each prescription of buprenorphine/naloxone and/or buprenorphine.

What to Expect when the DEA Comes to Your Office

  • 1 or more inspectors will identify themselves with a badge. DEA inspectors are required to present their badge to the physician.
  • The inspector will ask the prescribing physician to sign a Notice of Inspection, before proceeding with the audit. The physician’s Statement of Rights is clearly printed on the Notice. Take the time to review your rights.
  • The inspector may ask the physician to provide the following details:
    • Current DEA registration denoting “X” waivered status
    • Patient Prescription Log
    • Patient Dispensing Log (if dispensing)
    • Safe and secure area where buprenorphine/naloxone and/or buprenorphine stock bottle(s) are stored
    • List of patients receiving buprenorphine/naloxone and/or buprenorphine (list may identify patients by codes or numbers so as to protect patient privacy, see sample chart at ASAM website)
    • Physician’s access to behavioral health professionals.

How to Prepare for a DEA Audit/Inspection

  • Make sure you are in compliance with all of the above inspection elements and that all required documentation is readily accessible.
  • Notify your staff that the DEA is authorized to audit all waivered physicians, including this office. All DEA inspectors are trained to conduct these particular audits. Physicians and their staff should expect the audit to be congenial and efficient.
  • Staff is allowed to oversee the inspection. Identify and train one or two staff people on what to expect from the inspection and how to prepare for one.
  • Allocate a space in your office where the inspector and you/staff may continue the audit in private.
  • Be professional. Be cooperative. Know your rights.


Information on how to acquire a buprenorphine prescribing waiver, DEA Requirements for DATA-Waived Physicians, and what is covered in the Drug Addiction and Treatment Act of 2000 can also be found at: