Vochoa4190
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- Tacoma, WA
Can anyone help with this scenario?
In 2012, a MH provider sees the patient for psychotherapy 60min and bills 90806, but then 3 days later the patient has a crisis and calls a different MH provider at our clinic this different MH provider provides psychotherapy over the phone for 30min and bills 98968" Telephone Services provided by a qualified healthcare professional". Both share the same dx's, Is this appropriate coding?
I think this might be ok because the CPT book states "Likewise if the telephone call refers to a service performed and reported by the qualified health care professional within the previous seven days (either qualifed health care professional requested or unsolicited patient follow-up) or within the postoperative period of the previously completed procedure, then the service(s) are considered part of that previous service or procedure."
I interpret this as if the same provider performed the service/procedure w/in the previous 7 days then its considered bundled into the original service, but if its a different MH provider its ok to report the Telephone call. Plus, the Telephone call provider doesn't actually refer to a service performed within the previous 7 days. Do the providers need to be from different specialties/taxonomy?
Does anyone else read this differently? Any suggestions?
In 2012, a MH provider sees the patient for psychotherapy 60min and bills 90806, but then 3 days later the patient has a crisis and calls a different MH provider at our clinic this different MH provider provides psychotherapy over the phone for 30min and bills 98968" Telephone Services provided by a qualified healthcare professional". Both share the same dx's, Is this appropriate coding?
I think this might be ok because the CPT book states "Likewise if the telephone call refers to a service performed and reported by the qualified health care professional within the previous seven days (either qualifed health care professional requested or unsolicited patient follow-up) or within the postoperative period of the previously completed procedure, then the service(s) are considered part of that previous service or procedure."
I interpret this as if the same provider performed the service/procedure w/in the previous 7 days then its considered bundled into the original service, but if its a different MH provider its ok to report the Telephone call. Plus, the Telephone call provider doesn't actually refer to a service performed within the previous 7 days. Do the providers need to be from different specialties/taxonomy?
Does anyone else read this differently? Any suggestions?
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