Billing 90862 for a Medicaid patient

[mariak81586]

Is there an alternate code for 90862 that Medicaid will accept? I received a denial today, stating that they do not recognize it on their fee schedule.






Thanks,

Maria, CPC-A

 

[MnTwins29]

What was done?

Need more information on what was done to answer the question. Could be an E/M code, psychotherapy if the "minimal" amt of time was sufficient to use that code, etc.

What state are you in? NY Medicaid has recognized that code for a long time.

 

[deyoung]

Hawaii Medicaid also accepts 90862. I wonder if they are denying you because of frequency limits or the diagnosis not supporting medical necessity. In Hawaii, a patient is allowed only 12 in a given year.

 

[mariak81586]

re: what was done

Hi,

I'm in PA. 90862 was the only thing done on that date of service; Dr. saw patient at a nursing home.


-Maria

 

[di5sweet]

Is there an alternate code for 90862 that Medicaid will accept? I received a denial today, stating that they do not recognize it on their fee schedule.






Thanks,

Maria, CPC-A

Hello, If the patient has only medicad insurance. I suggest that using 90899 - unlisted pyschiatric service or procedure that the medicad or medi- cal will accept the service bill.

 

[mariak81586]

Isn't there a HCPCS code equivalent to 90862??

 

[dswords]

Medicaid of GA wants M0064. The physicians services manual states the following under Physician Services Limitations:

"When the sole purpose of the visit is to monitor or change
psychiatric medication, only code M0064 shall be billed"

 

[1073358]

Hi,

I'm in PA. 90862 was the only thing done on that date of service; Dr. saw patient at a nursing home.


-Maria

Are you sure that MA isn't denying because POS?