Wiki CP and testing req for info

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apmc

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Good morning!
I am hoping someone can help me figure out some issues regarding a Clinical Psychologist we are going to be billing for.
I got the impression from a different post that consult codes (9924_) are a no-no but what about 99408 and 99409?
Also, I cannot find any info as to whether or not we can do testing the same day as an exam (ex. 90801 and 96116). Does anyone know if we can do this?
Thanks in advance for any assistance you can give.
Peace.
 
We bill 90801 and 96101 for psych testing on the same day, as they are separate services. The 96116 is neuropsych and I have only used that for our neuropsychologist. I found that most insurance requires a medical dx when using 96116 or 96118. Hope this info helps.
 
I bill for testing - you can bill 96116, 96118 and 96119 on the same day of service...the 96116 is more of an exam where the 96118/9 are the testings. These are for Neuropsycholists, for regualr Psychological testing there are codes for that as well - I just do not know them off the top of my head as we rarely bill them, they are listed in the CPT just before the 96116. You can bill either mental health or medical diagnosis - this determines the type of coverage and what benefit the insurance will pay from.
 
apmc said:
Good morning!
I am hoping someone can help me figure out some issues regarding a Clinical Psychologist we are going to be billing for.
I got the impression from a different post that consult codes (9924_) are a no-no but what about 99408 and 99409?
Also, I cannot find any info as to whether or not we can do testing the same day as an exam (ex. 90801 and 96116). Does anyone know if we can do this?
Thanks in advance for any assistance you can give.
Peace.
Click to expand...

I would check with your Medicare carrier to see if you can bill the 99408-9. I think you can, but don't know for sure. To know for sure what codes you can bill together on the same day, check the CCI edits.
 
Big Thanks!

Thanks to all of you for helping me out. I really appreciate all your info and advice.
Peace
 
Our internal medical physician billed a 96118 with 314.00 dx code and BCBS of Illinois denied saying that "This service is handled by another carrier." BCBS of Illinois states that this service is considered "mental health" and requires a preauthorization for the test. They stated that we must send the claim to the mental health carrier for the plan. Has anyone had this issue before and does anyone think that the dx code determines whether the test is considered medical or mental health?

I would appreciate any advice on this issue.
Thanks
 
In your case, both the diagnosis and the service are considered mental health. And yes, many plans require preauthorizations prior to the service being rendered. Also, I do not see the reason for reluctance to submit the claim to the mental health carrier. Arguably, the internal medicine provider may not be considered a mental health practitioner, but the claim would still need to be submitted for payment.
 
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