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Z-codes- are some billable?

The ICD10Data.com site says this about the bereavement Z-code;

  • Z63.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes
  • That makes me think I CAN bill it. The client's Mental Health benefit detail link(BCBS,Availity) says that marriage counseling(another Z-code) is NOT covered but doesn't mention bereavement counseling.
  • Is there some unwritten rule about Z-codes that I don't know about?
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Fixed

Known Issue: Mirrors experiencing temporary delay

Kevin Holmes 8 years ago in Known Issues updated 8 years ago 3

Procentive's mirrors are experiencing a delay right now. You may experience blank pages, or a delay in saving. The problem should be resolved soon. Weill update this topic once the delay is resolved.

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Under review

Known Issue: Unable to kiosk clinical forms to a client who has declined client portal

Kevin Holmes 8 years ago in Known Issues updated 8 years ago 1

SCOPE: This know problem effects any customer that sends clinical charting forms through client portal AND the client has declined client portal.


DETAILS: The problem occurs when you invite a client to client portal and send the client clinical charting forms to complete. The client will receive two emails (one to register & one to open their portal to the forms). If the client declines their portal, then the client will not be able to access the forms from the second email. This also means the client will not be able to fill out forms on their own through kiosk in the future.


WHAT SHOULD YOU DO: At this time, you should only be aware of this issue when kiosking forms to clients.


We will provide updates here once we have more information.


Thank you.

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Under review

Possible Issue: Primary-Secondary payer "flipping"

Kevin Holmes 8 years ago in Known Issues updated 8 years ago 1

Possible issue -- in the client module/payer tab


SCOPE: This problem has only been confirmed for a single Procentive customer, and we have only been able to re-create the problem in the one database. So at this point, we do not know if the problem is widespread or very limited in scope. It is weird enough, however, that we wanted to let folks know about it.


DETAILS: The problem occurs when you open the client module/payer tab, and select to view the secondary payer. Once the system displays the secondary payer, it then automatically changes that payer to the primary payer. Even if you close the window immediately without saving, the system saves the changes (and moves what was the secondary into the primary position).

We have tested and recreated this behavior on Chrome and IE. We've only been able to recreate the issue on one customer database, and (even then) only for a very small number of clients. The problem is random in nature in the sense that it will happen for a client one minute, but not happen for the same client a minute later.

WHAT SHOULD YOU DO: If you see this same behavior in your database, or if you have had problems with the system "randomly" changing the client's primary and secondary payers, please send the client number in a ticket to the help desk.

We will provide updates here once we have more information.


Thank you.

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Medica Billing

mxiong 8 years ago in Billing/Electronic Modules updated by Teri 7 years ago 1

ome providers are having issues with billing Medica for mental health and chemical dependency claims since January of 2016 (change went into effect). Can anyone advise me on how they are billing these claims? Medica is requesting all residential billing be billed on a monthly basis and if a client misses one day (hospital, etc.) then the provider will need to bill that day(s) as a Leave of Absence (LOA). Has anyone billed this way? If so, could you provide some guidance regarding what revenue code you are using and what fields of the UB-04 form you are filling out to complete this claim? I appreciate your help. Thank you.

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Medica Billing for MH and CD

mxiong 8 years ago in Billing/Electronic Modules 0

I'm sure some providers are having issues with billing Medica for mental health and chemical dependency claims since January of 2016 (change went into effect). Can anyone advise me on how they are billing these claims? Medica is requesting all residential billing be billed on a monthly basis and if a client misses one day (hospital, etc.) then the provider will need to bill that day(s) as a Leave of Absence (LOA). Has anyone billed this way? If so, could you provide some guidance regarding what revenue code you are using and what fields of the UB-04 form you are filling out to complete this claim? I appreciate your help. Thank you.

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ARMHS Billing Question

John-Debbie Trunk 8 years ago in Billing/Electronic Modules updated by anonymous 7 years ago 3

Hi Community,


I'm hoping someone out in the community has an answer to this question.


If an ARMHS client has Medicare as their primary insurance payer and PMAP/MA as their secondary payer and is seeing a NON-Medicare provider, how to we bypass Medicare and bill the PMAP plan or the MA plan as the primary insurance plan? Do we need a modifier to do so?If a modifier is required, what is the modifier code used bypassing Medicare, billing PMAP/MA as the primary payer.


I'm advised we should bill Medicare first and get the denial then send the claim to the secondary plan, PMAP/MA.


Does anyone have experience with this? I'd love to hear from someone. Thank you for your time.

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Exposure Therapy

Tanya Leither 8 years ago in Billing/Electronic Modules updated 8 years ago 1

We have a therapist who wants to provide Exposure Therapy but we've never billed this before. Are there any pitfalls, tricks or do you find insurances won't pay for it?


Also, she wants 1-1/2 hour sessions - since there's not a code for this unless it's a crisis what code(s) work?

Thanks - any assistance would be appreciated! Kay

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workflow and workflow defeinitions

shsmark 8 years ago in Workflow Module updated by Sheryl Martin 8 years ago 4

I would love some feedback from anyone who has had a satisfactory experience with work flow and workflow definitions. How did you set it up and how is it working for your agency?