Wiki Phyiscals and Developmental billing

[luvsgoofey]

Anyone who bills for pediatric billing in Rhode Island any help would be terrific.

Trying to research billing for additional services such as developmental, ADD etc.
with phyiscals etc.

Provider mentioned billing
96110 & 96111
Anyone have any specifics.
Thanks
Dee

 

[HBULLOCK]

96110

I'm not from ri but i'm from mass. When it comes to 96110 this should be billed with rov's as long as drs are doing the screenings (peds, mchat, psc,crafft). This code requires a modifier of u1 ( no followup needed) or u2 (followup needed) when billing insurances. I find most insurances in new england will pay for this. Harvard pilgrim requires a modifier of 59(sometimes none at all), not the u1/u2. When it comes to add testing this should be done at a separate visit not during rov. Especially since some insurances won't pay for 2 visits same day. If your drs want to make sure they have 2 separate notes in record to show they performed both services and use a mofidier on the add visit. Hope this helps you. :d