Sotto007
New
Hi,
I work for a psychiatric office. I took over the billing from the physician's wife and earned my CPB in October after I was asked to take over billing. So, I'm new to this and no one in the office has any knowledge about coding and billing. Today, I came across something I have never heard before and I'm confused.
Anthem told me today that I cannot bill E&M codes for our physician assistant. I've been fighting Anthem since June about denied claims. They told me in June that the PA had been loaded into the group since February, and there should be no problems. Then they told me I needed to give them time to fix an administrative error. Now, they are telling me that I can only bill psychotherapy codes for a PA. They won't give me the contract or any paperwork that explains the rules. I can't find behavioral health rules anywhere.
I have had no other government or commercial insurance tell me that I cannot bill E&M codes for our physician assistant. Is this a real thing? Our PA sees patients for medication management and I typically bill 99203-99204, 99213-99214, and sometimes 90833 as an add on code.
Can someone help explain why Anthem is different from government and other commercial insurance? Can they really refuse to give me the documentation that explains the guidelines?
Thank you,
Sarah
I work for a psychiatric office. I took over the billing from the physician's wife and earned my CPB in October after I was asked to take over billing. So, I'm new to this and no one in the office has any knowledge about coding and billing. Today, I came across something I have never heard before and I'm confused.
Anthem told me today that I cannot bill E&M codes for our physician assistant. I've been fighting Anthem since June about denied claims. They told me in June that the PA had been loaded into the group since February, and there should be no problems. Then they told me I needed to give them time to fix an administrative error. Now, they are telling me that I can only bill psychotherapy codes for a PA. They won't give me the contract or any paperwork that explains the rules. I can't find behavioral health rules anywhere.
I have had no other government or commercial insurance tell me that I cannot bill E&M codes for our physician assistant. Is this a real thing? Our PA sees patients for medication management and I typically bill 99203-99204, 99213-99214, and sometimes 90833 as an add on code.
Can someone help explain why Anthem is different from government and other commercial insurance? Can they really refuse to give me the documentation that explains the guidelines?
Thank you,
Sarah