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Behavioral Health Visits

R

Ronilynn

Contributor
Messages
22
Location
Spanaway, WA
Has anyone billed a 90837 at 2 units for two hours and gotten paid for both units?
 
Prolonged service codes

Good morning,

In a case like that, I would bill 90837 + 99354 (a prolonged service code.) Hope that helps!

Chrissy Fegan, CPPM
 
Chrissy is correct this issue is addressed in the parenthetical note.

(Use the appropriate prolonged services code [99354, 99355, 99356, 99357] for psychotherapy services not performed with an E/M service of 90 minutes or longer face-to-face with the patient)
Click to expand...
 
Denials for 90837 + 99354

Our LCSW has done extended sessions that we have billed with 90837 + 99354, but have not received payment for the prolonged code. Has anyone had success getting paid?
 
Many times the 60 minute session requires prior auth, so I would assume the prolonged service would require the same. I would make sure the provider documented the need the the longer service and fight it on the back end.
 
Primary care Dr appt for 99213 then seen lcsw for 90832

If a patient seen primary care dr for 99213 then seen lcsw for 90832 on the same day, under the same tax ID. How would this be billed appropriately? Thank you
 
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