Wiki Multidisciplinary Coding and Billing

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Journey13

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I code for a specialty peds group that works with children who have autism, feeding disorders, mental disorders, etc. The practice includes 2 MDs, 1 PhD, I LCSW, and 1 neuropsychologist. They have within their practice 4 mini-clinics to assess and treat 4 specific types of conditions of their patient base: Eating disorders, Autism, Infants and Toddlers, Learning and Behavior. They have posed questions to me and my team that I'm having trouble finding any definitive information on. They would like to see the patients together, while each performing their own part of the mini-clinic. The MD would do the e/m portion while the PhD would do the psych eval, etc. Each of the mini-clinics would have a scenario like this, with teams of the 5 doctors working as 2s and 3s for whichever mini-clinic the patient is needing.
How do they bill/code for these types of encounters? The main carrier is Medicaid for this clinic and they are very strict in what they will cover.

Does anyone have any ideas or resources I can utilize to educate my group and help them get adequately reimbursed for these types of services?

Thanks,

Ruthie Deas, CPC
 
Hello,
We are a multispecialty group practice that is part of a University residency training program in Michigan. Our Peds Subspecialty providers also participate in a Medicaid CMDS (Children's Multidisciplinary Specialty) clinic for Cystic Fibrosis and Cerebral Palsy. It is a clinical designation that requires oversight from the Medicaid CSHCS program. What you are describing sounds like a very similar setup. We have to have a separate NPI. We bill for multiple physician visits and procedures that occur during the visit as well as a facility fee. Perhaps your state has a similar program to look into?


Here is a link with more general info about CMDS.
http://www.whatismedicalinsurancebilling.org/2017/11/cmds-childrens-multi-disciplinary.html

Hope that helps!
Stacie Ramsey, CPC
Revenue Integrity Specialist and Coding Educator
 
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