1. L

    Question coverage for 96127 for Aetna

    Does anyone know if Mental health providers (psychologist/trist) can bill 96127? We used to bill it with a 90846 or 90847 years ago, but we now know they are bundled. Has anyone billed this code on its own on a separate claim? or the day prior or the following day of the therapy visit? Any...
  2. L

    Question "New" patient debate

    I work for a behavioral health practice. We have a patient who has been with us in therapy for a couple of months. It's been determined that they need to seek medication management in addition to the therapy being provided. Our LPC has referred the patient to one of our Psych NP's for...
  3. M

    Question PT, OT and ST modifier HELP

    Can someone please assist me? NCCI edits state CPT code 97110 is a component of CPT code 92507. Would the modifiers GP (on 97110) and GN (on 92507) be sufficient to identify the two modalities as distinct and separate? Or would you need a XP, XS, XE, XU, 59?
  4. B

    SNF Therapy Audit help! Level 3 dispute!

    This is going to be long, and I apologize. I need some help from anyone with SNF experience, especially with billing of CPT codes. Here goes.... The first denial came back stating: "The 5 day assessment, ARD 8/3/17 pays for 8/1-8/3/17 and the 14 day/COT assessment ARD 8/10/2017 pays for...
  5. 0

    Searching for CPT: Cogmed Working Memory Training

    I have been searching for the most appropriate code for Cogmed Working Memory Training. It consists of using a computer (in part) for cognitive therapy. This therapy is sometimes used after TBI; however, it has been used to treat other conditions such as ADHD. The program is 25 sessions that...
  6. L

    Recreational Therapy

    Do you have or know where I can find information on what medicare covers regarding REcreational Therapy for patients with organic brain disorders, major depressive disorer, etc. patients are elderly - most with form of alzheimrs or dimentia. services by PT and NPP psychotherapist. Example of...
  7. B

    Nutritional Therapy

    Is it correct to bill cpt 97803 w/10 units according to documentation? Since it states each 15 minutes? thank you.
  8. T

    Occupational Therapy Plan of Care

    Is there a code that I can bill for an Occupational Therapy Plan of Care? I have researched and have not found one. thank you, Trish
  9. K

    Float Tank coding

    Has anyone had any experience with this type of therapy? Do you know what code would be appropriate for Float Tank/Isolation Therapy. Here is a link that describes what the float tank is or CPT 97022 kind of...
  10. B

    Billing Procedure for Sobxone Treatment

    I need assistance with the CPT code(s) that would be used for Drug Addiction Therapy. Our office will shortly begin using Suboxone therapy for treatment of drug addictions. What CPT code would be used for the Assessment which will include an Initial Comprehensive History and Physical, the...
  11. M

    Mental Health/Substance Use Disorder Group Therapy Case Notes

    Looking for "best practice" documentation of "group therapy" notes w regulatory citations - or without. Billing codes would be a nice feature also. If you have such a form or know a link, please do share. Thanks
  12. P


    Medicare is wanting a Therapy modifier on the 97610. This is performed in the office. Anyone know which modifier it should be?
  13. L

    EGD w/APC therapy

    What procedure code would you use for this example? EGD with APC therapy for non-bleeding duodenal ulcer.
  14. M

    Vibration Therapy

    My doc and I are having trouble finding a code for vibration therapy. I'm in a chiropractic office. The only codes we can come up with are unlisted procedure codes (such as 97139 or 97039). The vibration therapy I'm talking about is by a vibration platform, does not require constant attendance...
  15. M

    Wiki CPT 97110 vs. 97530

    Hello everyone! We are just about going batty over here trying to figure out exactly what can be billed under the CPT code 97530. Our therapists (PT and OT) tend to use 97110 and 97530 interchangeably, or they use 97530 for anything that may be considered an "activity" (ex: going to a movie...
  16. M

    Dexamethasone patch coding in Physical Therapy

    Does anyone know if there is an appropriate code for the "Dexamethasone patch" they use for iontophoresis in physical therapy?
  17. K

    Nutrition Therapy vs. DSME

    I have been trying to get precise definitions of these two different services. My understanding is that the DSME is a strict 8 - 12 hour course that covers everything from pathophysiology of Diabetes to Carb Counting and self administration of medications. The Nutrition Therapy is performed by...