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90791 Billing

akaeb

Networker
Messages
33
Best answers
0
We have a pt that came in for an assessment but was not able to finish on this day she came back a couple days later to finish the assessment. Are we able to bill 90791 for both days or can we only bill one 90791 and if so does it matter which day we bill this on?

Thank You!
 

KMilsap

Contributor
Messages
17
Best answers
0
I have this same question, and have been searching for an answer for days. Have you gotten any feedback on this elsewhere?
 

Lisapurple216

Networker
Messages
47
Best answers
0
The Medicare manual says you can, what we've found is you only get reimbursed for one. Typically what we do is hold the billing until the patient returns (hopefully) and then bill out on the day it's complete.
 

darmobsi

New
Messages
7
Best answers
0
90791 and psych testing

Hope this helps:

Psychiatric Testing and Evaluations
In some cases, for various reasons, psychiatric evaluations (90791/90792) and/or psychological
and neuropsychological tests (96101/96146) are completed in multiple sessions that occur on
different days. In these situations, the date of service that should be reported on the claim is the
date of service on which the service (based on CPT code description) concluded.
Documentation should reflect that the service began on one day and concluded on another day
(the date of service reported on the claim). If documentation is requested, medical records for
both days should be submitted.
Psychiatric Testing when provided over multiple days based on the patient being able to
provide information, is billed based on the time involved as described by CPT and the last
date of the test. For more information, see the Medicare Benefit Policy Manual, Chapter
15, Section 80.2, at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/
 

LMBENHOFF

Contributor
Messages
18
Location
Rockford, Illinois
Best answers
0
Hope this helps:

Psychiatric Testing and Evaluations
In some cases, for various reasons, psychiatric evaluations (90791/90792) and/or psychological
and neuropsychological tests (96101/96146) are completed in multiple sessions that occur on
different days. In these situations, the date of service that should be reported on the claim is the
date of service on which the service (based on CPT code description) concluded.
Documentation should reflect that the service began on one day and concluded on another day
(the date of service reported on the claim). If documentation is requested, medical records for
both days should be submitted.
Psychiatric Testing when provided over multiple days based on the patient being able to
provide information, is billed based on the time involved as described by CPT and the last
date of the test. For more information, see the Medicare Benefit Policy Manual, Chapter
15, Section 80.2, at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/

THANK YOU!

I was thinking the same thing! Payers often wont pay more than 1 Eval per year, I couldn't see how we could charge multiple Evals that span a few days and have them reimbursed.
 
Messages
179
Best answers
0
hi this institution does testing for children that have significant educational disabilities. Typically this is not covered by insurance can anyone recommend what cpt code to use for this?

thank you
 
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