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Co-occurring Diagnosis

Jill 6 years ago in Codes/Rates/Diagnosis Modules updated 6 years ago 2

Good afternoon!  This may be a basic question, but at the risk of sounding "un-informed" I'm going to ask it anyway :)


I was recently made aware that a modifier can be used on claims to indicate when a client has a co-occurring diagnosis.  For example, a chemical dependency diagnosis along with a mental health diagnosis.  I was told that this could potentially result in a higher payments.  Do you know if this is the case and what that modifier is?


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Does anyone bill H0015 codes

Kim Ross 6 years ago in Codes/Rates/Diagnosis Modules updated by Karen P 5 years ago 2

We are newly licensed Rule 31 and Cigna let us know that they reimburse H0015 for outpatient CD services. 

Does anyone else have experience billing H0015?

Thanks,

KIM

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Add on codes

Currently setting up Procentive and am wondering how add on codes work in the system.  Example the add on code for interactive complexity (90785) or travel code (H0046).  Have tried to send a few codes through by using the override overlap button in the Time Module on both the service line and the add on line but when I get to the billing module I get an error that the add on codes are not attached to a service line and cannot be billed electronically. Is there a better way to do this?

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90899 Information

John-Debbie Trunk 7 years ago in Codes/Rates/Diagnosis Modules updated by Sheryl Martin 7 years ago 7

Hello , ,


Is there anyone who can provide information regarding CPT Code 90889. What kind of process do we need to follow to get reimbursed for this codes. Is it covered by PMAP plans, MA, Commercial Payers, if so which ones?  Does it require prior authorizations. Thank you.

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Add on Psychotherapy codes 90833, 90836 and 90838

We are looking for clarification on understanding of time/minutes for the 90833, 90836 and 90838.  Per the CPT code book a 90833 is 30 minutes of psychotherapy with patient when preformed with and E/M service.  We took a few trainings a few years back when the 90853 med management and 90805 med manage w/ psychotherapy codes were removed and were informed that we could bill a 90833 for any psychotherapy provided outside of the E/M time for time spent between 16-37 minutes. i.e Prescriber did 99213 E/M services then provided 18 minutes of psychotherapy so they would bill the add on code of 90833 in addition.  What time/minutes do you associate with the add on psychotherapy codes?  We understand that no one can advise on what to bill just want clarification on the minutes or span of minutes for each code. 

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What billing codes are practices using for clients that would be taking ADHD testing such as Tova on the computer?

Kelli Feucht- ACS 7 years ago in Codes/Rates/Diagnosis Modules updated by Richard Sethre, Psy D , L P. 7 years ago 1

Providers have clients come to office to take a 20-40 minute ADHD test using TOVA, which is a computerized test.  We would like to bill to insurance, has anyone ever billed for these types of services, if so what code(s) are you using?

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80300 and 80301

Does anyone know which codes replaced the 80300 and 80301 for Drug tests?

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Testing

Jill 7 years ago in Codes/Rates/Diagnosis Modules updated by Richard Sethre, Psy D , L P. 7 years ago 2

Good morning!  I am wondering what experience others have had with billing the testing CPT codes. The specific tests I am looking at would be the MMPI and the MAPI.  I believe this would fall under the 96101?  Some of the questions I have on this is - what is the reimbursement rate like?  How many hours are you able to bill for?  Are you paid separately for the test administration and the write-up or is this one code?  Does this need to be billed along with a DA?  If anyone has a chance to give their thoughts on this it would be greatly appreciated!

Thanks & have a great weekend!

Jill

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Family Therapy codes changing

sandy 7 years ago in Codes/Rates/Diagnosis Modules updated by anonymous 7 years ago 9

Does anyone know what the "time based code" changes are for family therapy?


Billing changes for family psychotherapy: Effective January 1, 2017, CPT codes 90846 (family psychotherapy without patient present) and 90847 (family psychotherapy with patient present) have changed to a time based code. Review CPT code guidelines for additional information. The calendar year limits for these services remain the same. Authorization is required if a person needs more than the yearly threshold.

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Does anyone have experience billing code 96101, psychological testing?

sfoster 7 years ago in Codes/Rates/Diagnosis Modules updated by Richard Sethre, Psy D , L P. 7 years ago 13

Does anyone have experience billing code 96101, psychological testing?