1. M

    Therapy Billing

    I recently started billing and coding for a Therapist/Counselor for substance abuse. I am billing all insurance as out of network. My claims are continuously getting denied. How should I be billing out of network for a substance abuse therapist?
  2. D

    Codes DOAC (Direct Oral Anticoagulant) Counseling

    How do you code/bill for DOAC (Direct Oral Anticoagulant) safety counseling with patients? What are the proper codes. I was only able to find codes for warfarin and INR monitoring (93792 & 93793). Thank you!
  3. S

    Using Counseling/Coordination of Care Time vs Key Components - whichever is higher?

    I'm wondering if you would assign the E/M Level based on the Counseling/Coordination of Care time if it is LOWER than what the documentation meets (within the Hx/Exam/MDM). The guidelines indicate that when the encounter is dominated by counseling/coordination of care than TIME should be the...
  4. H

    Coding for non face to face

    I am coding for a physician who has met with the parents of an older autistic child. The child could not make the appointment. The Dr. discusses the patient's care with the parents and fills out FMLA paperwork. Does anybody know if this encounter is billable and if so, what ICD 10 and E/M codes...
  5. J

    Group- Substance/Alcohol Abuse

    I am in Arizona and bill for a counselors office. I am wondering which code to use for a group therapy that is for substance and/or alcohol abuse. It is an intensive outpatient therapy but not all of the patients attending the group sessions meet the HCPCS requirement for the group (H0015; which...
  6. H

    contraception initiation

    I understand that birth control counseling is included in the preventative visit. If the patient is counseled and decides on a new form of contraception should that go on a separate E/M? That is how I have been instructed to do it, which seems wrong to me. Does the insurance company still pay...
  7. A

    Advice for behavioral health EMR/PMS ?

    Hi all, I hope this is allowed to ask for product recommendations. If not, please remove this and I apologize. My agency is a center for counseling and is currently undergoing the process to becoming Medicaid contracted. We are meantime looking to update our practice management system to not...
  8. A

    LCSW In home E/M and psychotherapy

    Trying to get an LCSW to provide in home psychotherapy/counseling to a patient who is covered by Cigna primary and Medicare secondary. Cigna advises that they do not accept CPT codes 90791 or 9083x for in home psychiatric assessments or psychotherapy and advised me to utilize E/M codes...
  9. N

    Wiki ICD-10 code for "travel"?

    We have patients come in to get immunizations updated for foreign travel. The provider reviews their immunization records, history, etc, and so there is an E/M charge. I haven't found a code specific to "travel advice" so I've been using Z71.89 (other specified counseling). Most insurances...
  10. T

    Smoking and tobacco use cessation

    Is anyone having a problem getting these codes paid 99406 or 99407. We are using dx F17.210 along with whatever problem the patient came if for and with the proper documentation of the provider counseling the patient. We are also adding a 25 modifier on the office visit. Is there something...
  11. S

    Vaccine admin codes HELP PLEASE!!

    If a patient comes in and only sees the nurse for shots & they hand them a sheet about the vaccines, would this be enough to qualify as counseling to support using 90460 instead of 90471?
  12. G

    Counseling--Banging My Head Against Wall!

    I have a provider who thinks every visit is based on counseling. She counsels them on "everything," or so she says. I've tried to talk to her about this and convince her that in her family practice area, very few visits should be coded based on time. Are there any good resources that I could...
  13. E

    Counseling and Coordination of Care

    In the Edge Blast #123 - Question # 3 I beg to differ: Answer should be 99213, 99401 as opposed to 99212, 99401. Assumption 15 minutes of time spent counseling the patient constitutes more than 50% of the E&M and time becomes the key factor. That is, 15 minutes out of 25 minutes (99212...