I did an analysis of billed R69's to see who was paying them. (These are generally a first appointment with a parent only--90846.) We have been paid for this diagnosis by Health Partners, PrimeWest, BCBS, Preferred One and America's PPO. We have not been paid by Medica or MA. Their denial description states "Diagnosis not consistent with procedure".

Is anyone billing this as a Z71.1 or a Z03.89? Are you being reimbursed by Medica and/or MA? Thanks in advance!

Sheryl

We are experiencing slowness everywhere

Hello,

Has anyone had claims deny from Health Partners with the code 50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.)?

Since January 1 all our psychotherapy codes have been denying with this code...weird.

Thanks

What do most providers use as a diagnosis for billing when clients come in one time and the therapist does not get enough information to complete a diagnostic assessment?

Anyone receiving denials from BCBS Federal for DBT H codes done via telehealth?  We are getting pushback from them and lots of different answers for MH services in general done via TH stating these services need to be done through Teladoc.  

Is anyone having issues with signing into Therapy Brands? We are getting a message: "can't reach this page". This is also affecting E-Prescribe capability.

Hi Everyone,

I am wondering how you all are handling this transition of new Optum payers that have been added so that we can send the U5 modifier with the DQ qualifier for our clinical trainees. Specifically, if you have a clinical trainee and a licensed provider seeing the same client with one of the payers that procentive split so clinical trainee and licensed people are billing different payers in procentive.

Any feedback on this change would be appreciated! 

Effective December, Medicare and plans are denying any F43 code (F43.1, F43.23 etc).