Wiki Psych

[tdbear612@yahoo.com]

We have started getting denials from Cigna and Cigna medicare for CPT's 96132, 96133, 96138, 96139 stating Plan procedures not followed. The Cigna representatives are not able to clarify this denial, has anyone else been seeing this. The diagnosis is per their policy. Thank you

 

[TThivierge]

We have started getting denials from Cigna and Cigna medicare for CPT's 96132, 96133, 96138, 96139 stating Plan procedures not followed. The Cigna representatives are not able to clarify this denial, has anyone else been seeing this. The diagnosis is per their policy. Thank you

What are the dx code using for these CPT codes? Also per the CPT manual you can bill same day and SAME therapist or psych doc using CPT 90791, 90832-90847 but need to document at least 16 minutes for just these CPT 96132-96139 and documentation record amount of minutes on therapy vs type of care . Used for patients have language problems or cognitive dx . See dx F80, R41, I69.02, R47, F98.
I hope this data helps
Lady T