Question Neuropsych testing codes 96136 and 96137

nwhite123

Networker
Messages
25
Location
Madison, WI
Best answers
0
Can you tell me the guidelines on billing the testing codes: 96136 and 96137?

We recently have run into insurance companies who are telling us that we cannot bill more the 11 units of 96137 per day due to the MUE guidelines. We were under the understanding that the 96136 could only be billed once per an evaluation so how can you bill the 96137 on multiple days without billing the primary 96136 code?

Can we bill up to 11 units of 96137 on one day and bill the remaining units (if applicable) the next day?
 

SharonCollachi

True Blue
Messages
1,753
Location
Clovis, CA
Best answers
3
The MUE is telling you that it is unlikely that you will be doing more than six hours of testing in one day. Frankly, I would probably consider 6 hours to be abusive.

The NCCI edits were updated a couple of years ago to allow one 96136 on one day, and 96137 on subsequent days without a 96136. Bill everything on one claim, just separate the days for the 96137.
 
Messages
5
Best answers
0
Can you tell me the guidelines on billing the testing codes: 96136 and 96137?

We recently have run into insurance companies who are telling us that we cannot bill more the 11 units of 96137 per day due to the MUE guidelines. We were under the understanding that the 96136 could only be billed once per an evaluation so how can you bill the 96137 on multiple days without billing the primary 96136 code?

Can we bill up to 11 units of 96137 on one day and bill the remaining units (if applicable) the next
The MUE is telling you that it is unlikely that you will be doing more than six hours of testing in one day. Frankly, I would probably consider 6 hours to be abusive.

The NCCI edits were updated a couple of years ago to allow one 96136 on one day, and 96137 on subsequent days without a 96136. Bill everything on one claim, just separate the days for the 96137.
are you billing the 96132 and the 96133.
The 96136 and 37 is the scoring codes so I don’t believe you would need 11 units
 
Top