90792 How many times can this code be used for same patient?

jsquinto

New
Messages
2
Best answers
0
I work for a Behavioral healthcare practice, and the providers have asked if code 90792 is only for New Patients or is it a code that can be used for the same patient at the patients? next visit? Patient is seen every 2-4 weeks.

I thought that this was for a new patient/Initial visit and could only be billed once a year.

Can someone clarify this for me?:confused::confused::confused::confused:
 

MorrowL4

New
Local Chapter Officer
Messages
2
Best answers
0
Per CPT - Codes 90791, 90792 may be reported more than once for the patient when separate diagnostic evaluations are conducted with the patient and other informants. Codes 90791, 90792 may be reported once per day and not on the same day as an evaluation and management service performed by the same individual for the same patient.

In my facility we were told no more that 3 times per year and can only be used more than once when either circumstances change, new provider, or long lapse in service.
 

jsquinto

New
Messages
2
Best answers
0
MorrowL4, thank you for your explanation. I like your facility rules, will have to let my providers know.:rolleyes:
 
Messages
1
Best answers
0
Billing 90791 even if the patient is not new?

Can I bill 90791 again for a patient when a new problem arises even though the pt is not new to the provider?
 

julie@medexplus.com

Contributor
Messages
14
Location
Fort Lauderdale, FL
Best answers
0
I am trying to get the 90792 through for an IOP facility for a client with SA DX and getting error message. I have used rev code 900, which I would normally get paid on for 90791. The BCBS rep said per the guidelines use 906, rejected on both ??? Bill type 131
Any advice would be greatly appreciated.
 
Top