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Screening detects alcohol, drug abuse problems: new codes for health providers released to improve reimbursement.

Every day, in every state in the nation, thousands of people visit health care providers. They are weighed, their blood pressure is recorded, they are asked about their symptoms. And more and more often, they are also being asked a set of questions aimed at steering those at risk for alcohol or drug use problems toward treatment.

Through growing acceptance of a method known as screening and brief intervention, more patients are being evaluated for alcohol and drug abuse and being encouraged to seek help if there is a problem. Under screening and brief intervention, health care providers--whether they are in a doctor's office, emergency room, health department or community clinic--administer patients a short set of questions about alcohol use, usually starting with whether they use alcohol or drugs. Depending on how patients respond, they are asked additional questions to determine their risk and provided with materials and advice for changing their behavior.

Screening and brief intervention has been shown to decrease the frequency of alcohol and drug abuse, reduce the risk of trauma and increase the percentage of patients who enter substance abuse treatment, according to the U.S. Substance Abuse and Mental Health Services Administration. The method has shown such promise that SAMHSA is funding a screening and brief intervention demonstration project in 17 states, with more than 460,000 patients screened as of January 2007.

Results to date from the demonstration project show that 15 percent of patients received a brief intervention, about 3 percent received brief drug treatment and another 3 percent were referred to specialized drug treatment programs, according to data presented at APHA's 135th Annual Meeting by the White House Office of National Drug Control Policy. A follow-up six months later showed "significant declines in substance abuse after the brief interventions."


Such results are "very positive," according to Bertha Madras, PhD, deputy director for demand reduction within the White House Office of National Drug Control Policy. According to the office, more than 20 million Americans meet the medical definition of alcohol or drug abuse, but about 94 percent of them are unaware that they need help and have not sought treatment. Screening and brief intervention is an ideal way to reach those at risk and "to get them the help they need," Madras said.

At the urging of the White House Office of National Drug Control Policy, the American Medical Association released a new set of Current Procedural Terminology codes, commonly known as CPT codes, in October for substance abuse screening and brief intervention. In 2006, the Centers for Medicare and Medicaid Services approved its own codes so that providers can receive reimbursement for the screenings under Medicare and Medicaid. With both sets of new codes in place, it will be easier for health and medical providers to demonstrate that screening was performed and therefore be eligible for reimbursement from insurers for the service.

"Having the codes, it's now a procedure that can be taught, reimbursed and really mainstreamed into medical practice," Madras told The Nation's Health. "This is a procedure that needs to be used widely."

In addition to the state-based demonstration projects, SAMHSA has funded campus-based projects and is working to provide resources for trauma centers. Health care workers within the Indian Health Service are also being trained to use the method. Many private sector organizations are also helping to promote screening and brief intervention, including APHA, which has focused on the method through its Public Health Traffic Safety Institute, which is supported by the National Highway Traffic Safety Administration.

"In every possible sector, we are very committed to using our federal partners to distribute the wisdom of this," Madras said.

Madras encouraged public health workers and medical practitioners who want to learn more about screening and brief intervention to seek out continuing education opportunities on the method. More information on screening and brief intervention can be found online at www.whitehouse, www.sbirt. and www.

SAMHSA is now seeking applicants for grants to states and tribes to provide screening and brief intervention programs, with about $10 million in grants to be awarded. For information, visit www.samhsa. gov and search for TI-08001.
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Title Annotation:The NATION: Health news at the national and federal levels
Author:Late, Michele
Publication:The Nation's Health
Date:Dec 1, 2007
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