Wiki 90849 MULTI FAMILY GROUP THERAPY

Rapidrev

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HI ALL, DOES 90849 REPRESENT MULTI FAMILY GROUP THERAPY WITH OR WITH OUT PATIENT PRESENT? I HAVE SEEN BOTH DESCRIPTIONS 2018 AMA CPT DOES NOT SPECIFY WITH OR WITH OUT PATIENT, BUT OPTUM 2018 BEHAVIORAL HEALTH CODING PAYMENT GUIDE STATES TO REPORT 90849 WHEN PATIENT IS PRESENT? IF PATIENT IS NOT PRESENT, ARE WE TO BILL THE INDIVIDUAL FAMILY MEMBERS PERSONAL INSURANCE FOR THIS SERVICE AND IF SO, WHAT WOULD BE THE DX CODE TO USE. I RESEARCHED AND FOUND THAT V61.20 COULD BE USED WHEN PATIENT IS NOT PRESENT. NEED SOME CLARIFICATION ON THIS PLEASE, I HAVE A FACILITY THAT DOES PROVIDES GROUP FAMILY THERAPY WITH PATIENT AND GROUP FAMILY THERAPY WITH OUT PATIENT. ALSO DOES ANYONE HAVE AN HISTORICAL DATA OF WHAT THE MAJOR PAYER WOULD REIMBURSE FOR THIS SERVICE FOR OUT OF NETWORK FACILITY, AND ARE WE BILLING ON UB04 UNDER FACILITY OR HCFA ? ANY HELP AND FEED BACK WOULD BE GREATLY APPRECIATED ! :} THANK YOU
 
In the behavioral health book by optum prior to 2019 it stated must include the patient. I asked the question at the national conference to OPTUM and CPT as well as followed up with an email. Optum had to go back to the intention of the code when first created and informed me the patient must be present. they will correct that for 2020.
 
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