sjooemmy08
Networker
Hello, I work for FQHC and I have a question regarding PPS reimbursement.
The claims are created on the EMR system, and I fill in the claim form and correct
what has to be fixed to be appropriate. Then I split the claim into HCFA and UB(O/P wrap)
so that each one can be submitted to corresponding places.
HCFA shows whatever CPT codes I have used, while the UB form for PPS reimbursement
shows T1015 code with modifier SE on top of the CPT codes no matter what.
They have been being paid all along.
But my boss told me that Behavioral Health encounters need to be a different code.
She doesn't know which one specifically but was so confident that it has to be a different code.
DOES ANYBODY HAVE AN IDEA WHAT THAT CODE WOULD BE?
The claims are created on the EMR system, and I fill in the claim form and correct
what has to be fixed to be appropriate. Then I split the claim into HCFA and UB(O/P wrap)
so that each one can be submitted to corresponding places.
HCFA shows whatever CPT codes I have used, while the UB form for PPS reimbursement
shows T1015 code with modifier SE on top of the CPT codes no matter what.
They have been being paid all along.
But my boss told me that Behavioral Health encounters need to be a different code.
She doesn't know which one specifically but was so confident that it has to be a different code.
DOES ANYBODY HAVE AN IDEA WHAT THAT CODE WOULD BE?
