Wiki Billing An Initial assesment longer than 1hr

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gmartingt

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What is a good code to use in an initial assesment longer than one hour? We use 90801 now. So when the appointments go over 1 hr can another code be used or a modifer? Was looking at modifer 22, but not sure.

I am new at this so any information would help!

Thank you
Gretchen
 
Since it is not a time-based code, I'm not sure that the fact that the assessment took longer than an hour is billable. You could try billing it with a 22 modifier; however, the insurance companies that recognize the modifier will probably ask for records before they will pay the claim and they may decline to pay more than the 90801 rate since it's not a time-based ocode.
 
gmartingt said:
What is a good code to use in an initial assesment longer than one hour? We use 90801 now. So when the appointments go over 1 hr can another code be used or a modifer? Was looking at modifer 22, but not sure.

I am new at this so any information would help!

Thank you
Gretchen
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Hello Gretchen,

http://www.trailblazerhealth.com/Tools/LCDs.aspx

Try this website for more advice. I believe you can use the 22 modifier if it takes extensive time. I wouldn't recommend using it on every single initial psychiatric examination. It may raise a flag.
On the link, accept and enter 90801. From there select the folder below for more detailed information.
Per the link only 3 per year are allowed.

Hope this helps : )

Barbara
 
Did you find your answer

Did you find your answer? I have a few comments and they deal with the providers contract with some additional findings.
 
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