Wiki More clarification on Family therapy

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shermanboise

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What V codes for family Dx are most likely to get reimbursed, if any? Also, my therapists are LCPC's as apposed to Psy.D. or Ph.D., and are under the impression that they are limited to using certain cpt codes, is there any truth to this. How is it that they have this overwhelming feeling that they will be denied reimbursement if they bill 90847?
 
I am not sure about the first part of your question (V codes) but as for the question about them being limited to using certain CPT codes they may be right. I was looking through a Medicare Local Coverage Determination (LCD) (you may want to goto the CMS website and look up the LCD that pertains to your area) and it says they would have to be authorized by the state stature to perform psychotherapy. It depends on your state but they may be able to perform psychotherapy being a non-physician as long as they are "authorized" (probably additional training/certification).
 
Take it easy 1073358...remember she mentioned she is new to this and is looking for advice. They may not have started their program yet and may be looking at creating a program for a specific type of condition.

Yes, once the patient is seen then we should code by condition not reimbursment. But prior to seeing, in general - not necessarily a specific patient, you can contact your local payers to see which codes they allow. I would just call the major payor in your area (like a Blue Cross and Medicare plan).
 
Idaho, please don't get upset. I fully agree with the right way to code. I'm trying to get information to defuse a situation between my providers, myself and the payers. Most of my questions are from my providers rebutles, to my questions of "why are you not billing this as 90847." So please bare with me.
Thanks,
B.
 
I am not at all upset with anyone, just wanted to make a point that has been drilled into my head...

I think that sometimes coders get wrapped up in what each company will pay and what each wants and they tend to start kicking correct coding to the wayside..

As the other member had said, I would check with your states Medicare website. Thats what we base everything off of here, is our Medicare. We bill all insurances the same as Medicare to keep consistency.
 
I tried to look for info in Idaho, but I dont have alot of time right now. If you find something and want more info, poat again and I/we can try to further help
 
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