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DA Billing Question
Heather Wadie hace 5 años
en Billing/Electronic Modules
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actualizado por Richard Sethre, Psy D , L P. hace 5 años •
4
We have a client that was being seen for a diagnostic assessment, but the client walked out after 20 minutes. Has anyone else had a situation like this and if so, how did you bill? It doesn’t seem to fit the DA requirements, but maybe it can be billed as an individual psychotherapy session?
Servicio de atención al cliente por UserEcho
Not for 20 minutes; too short.
Yes, you can--only 16+ minutes is needed to bill for a 30 minute session, but what code would you use for the diagnosis?
Don't know if this is a MA client, but there is a list of R45 codes they have approved for initial sessions:
90791 is a"unit-based" code, not a "time-based code," so there are no time requirements. You should, however, document the start and end time. The 16 minute criteria applies to 90832, nor to 90791.In this case it seems pretty safe to bill for a 90791 - especially of the patient/client/person's behavior during the brief encounter provides info about a possible diagnosis and/or treatment issues. If in doubt, talk to the insurance company's provider services staff.