Wiki Billing help!!!!!!! Psych md

[jgarcia619]

I have a psych MD that bills United Behav Health (UBH). He bills a 90809, but UBH denied the claim stating to bill at contracted CPT. UBH will not pay for anything higher then a 90807. MY QUESTION IS..... Can the psych Md change his billing from a 90809 to a 90807 to receive reimbursement?


jen

 

[wyawn]

Hello Jen,

I personally do not see a problem with a physician changing the coding from 90809 to 90807 since UBH does not recognize the 90809 code. With the various payor CPT issues in contract negotiations and allowable codes this happens quite often; especially if it was billed to the wrong payor and the new payor wasn't added into the billing system first.

Does anyone else have a different response?

Wendy, CPC
*Behavioral Health*