Wiki New To Psychology Need Help

[cpeele]

Just started coding for a Psychologist in Oct 2012. She has been billing 90806,
and Medicare is rejecting as "not a certified provider". Can my Psychologist bill
for this Code? Not finding much on the CMS Website about this.
Thanks, Christy Peele, Dothan Alabama cpeele@ecmamd.com

 

[carrb@waynearc.org]

Yes 90806 is a valid code until 1/1/13. Now the code would be 90832 (30 min),
90834 (45 min), 90837 (60 min).

 

[cpeele]

Thank you for your input. Do you have any Idea why Medicare
is rejecting the 90806 for 2012 as "provider not certified"? She is
a Psychologist not a psychiatrist. Thanks again

 

[djolly]

Is she actively enrolled with Medicare? Usually this is an enrollment issue.

 

[mstroman]

Thank you for your input. Do you have any Idea why Medicare
is rejecting the 90806 for 2012 as "provider not certified"? She is
a Psychologist not a psychiatrist. Thanks again

This is sounding like it is a provider enrollment issue - you would do well to place a call to Medicare to find out exactly why the service is being denied. Hope this helps.

 

[rebeccamoorecpc]

If it's not an enrollment issue, it may be a modifier issue. Since the provider is a psychologist rather than a psychiatrist, it might be necessary to use an "AH" modifier to reference the type of provider who conducted the service.