We are contracted for these codes w/ Medica and UHC. It has been a nightmare going back to 2017 trying to get these codes authorized and paid. We have been working with our provider relations rep and are sending her all denials.

Now they are telling us it is more widespread than just our clinic. Just wondering if anyone else has the same issue.

Thanks....Tina

Is anyone billing the 99070 code? Here is the info:

CPT Code:

99072

Description:

Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other nonfacility service(s), when performed during a Public Health Emergency, as defined by law, due to respiratory-transmitted infectious disease

Lay Description:

Code 99070 is adjunct to basic services rendered. The physician or other qualified provider reports this code to indicate supplies and materials provided over and above those usually included with an office visit or services rendered. This code does not include eyeglasses; report the appropriate supply code if eyeglasses are provided. List drugs, trays, supplies, and other materials provided when using this code. Code 99072 reports additional supplies, materials, and clinical staff time necessary to perform safety protocols during a public health emergency (PHE) due to respiratory-transmitted infectious disease. Extra precautions, over and above those usually included in an office visit or other non-facility services, are taken to ensure the safety of patients and health care professionals during in-person interactions while allowing for the provision of evaluation, treatment, or procedural services. Use of this code does not depend on a specific patient diagnosis.

Notes:

Includes supplemental reporting for services adjunct to basic service provided.

Includes additional supplies, materials, and clinical staff time required for patient symptom review, personal protective equipment (PPE) use, and heightened cleaning processes due to respiratory-transmitted infectious disease during a declared public health emergency (PHE), as defined by law.

Excludes reporting more than one time per encounter, despite number services provided during encounter.

Excludes Supplies and materials provided, above those normally included in the encounter, unrelated to a declared PHE (99070).

Hello

Can anyone tell me if you can bill a 90791 on the same date as a 96130, 96131, 36, 37?

We are some what new to the ARMHS program and are having issues with denials for MN MA... We have Mental Health Practitioners trying to bill individual services (H2017).

(They are Mental health practitioners NOT Mental health rehabilitation workers that would use the H2017 HM) 

Mental Health Practitioners are not licensed so need a supervisor. Yet, our supervised claims have a HN modifier on them.  Call center tells us that the claims can't have HN.  However, if we bill without the HN it will look like Supervisor is the one providing the service.   Any help would be greatly appreciated!!  They way we are billing works for Blue Plus and UCare PMAP..   Thanks!!

We have had denied CTSS group claim payments since July of 2020. I am in communication with BluePlus to get this resolved but its a slow process and these services should be covered. Is anyone else have this issue?

I work at an adolescent inpatient treatment facility and occasionally we admit clients who are 18 or turn 18 during their treatment stay.  This year Ucare pmap are paying a reduced rate after their birthday however they are receiving the same services which includes high school services.  Has anyone else experienced this?  The rate is being reduced from 216.34 to 179.25.   

Does anyone know what facility type code we should use for drug testing codes such as 80305 & 80307. I've been using code 89 but one payer is denying our claims because it's the wrong facility code type. They won't tell me what code they want us to use and they just said to talk to our biller. I am the biller and I've not been able to find this information. If anyone can assist please reply. We do drug test lab screenings at our facility. Thanks.

Hi,

We are submitting for CLIA waived UA testing. The claims are denying as the Certificate # needs to be on the claim.

Does anyone know where this Cert # is to be entered in the payer, code or on the claims? We do not receive auths for this service.

Thanks for your help, Teri

Questions for billing Interpreter services to a p-map for CD services: 

Do we enter one individual session for the whole day the interpreter was here?

Who do we use for staff? 

Thank you for any help you can offer.

Has anyone had any success with billing Veterans Affairs for SUD residential services or SUD outpatient services through Procentive or through their portal? We are getting rejections from the clearinghouse for services billed through Procentive and denials about dates overlapping in their portal which doesn't make sense.