Wiki Coding Updates and Information

[ccbouchard]

I work for a billing company that handles multiple specialties. I am their only coder for 32 practices and I only have my CPC, so I am only generalized. I have all our practices running well with a 98% turnaround with aging. My boss is now wanting me to begin researching and finding revenue that our practices may be missing out on. He is starting me with our pediatric offices and expects a response from me by Tuesday morning, and he is just now informing me at 4:45pm on Friday. Does anyone have any guidance for me on this type of research? How I can find information on all possible billing procedures and ensuring our offices are billing to their full potential? Currently our offices are billing sick and well visits, all the basic testing, vaccinations, and screenings. They are all currently trying to bill for mental health diagnosis and screenings as well, but are continually denied because the patients medical plans do not cover mental health and the providers are not enrolled with mental health plans. Any help or advice would be greatly appreciated.
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[TThivierge]

Hi CCBouchard
I d Goggle each medical specialty to see what may bill and documentation to support it. Then look in corresponding section of CPT manual. I suggest get those MH therapist and clinicians enrolled in differ payer networks ,You could also have your fiscal person get up a contract with patient if insurance not cover set up payment plan but I d always bill to payer and get denied as proof why set up self pay plan. Have you got a video or phone call set up for established patients with some medical services ? Licensed providers..( NP PA DO MD) use phone call 99441-99443 ensure add minutes talk on record, get patient permission and verify on each record it is permitted. Cover with each payer see if cover videos or phone calls. Unlicensed therapist or QHP or RN calling use CPT 98966-98968. Ensure add proper plan of care and diagnosis codes too for phone calls/videos. Oh yes can use modifier 95 or 93 if use Eval mgn CPT codes.

I hope this data will help you
Lady T