Wiki Split Billing vs. Combining DOS 96116 96118

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tetzlaffanne

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Hello,

I am billing for a provider in the state of California. I have found no policy on this topic from Palmetto. The only policy I was able to find applies to WPS (Midwest states).

If the provider does testing on 1/1/12 and then finishes up testing on 1/2/12 and then does his report/interpretation on 1/3/12 for 96118 or 96116 -- how do we bill this?

Do we split it out based upon time spent for each DOS? Or, do we combine time and bill it all on the last DOS (as per the WPS policy)?

Can anyone provide me with a definitive reference saying one way or the other?

Thanks!
Anne Tetzlaff, RHIA, CPMA, CCS-P, PCS, CPC, CFPC
 
96116 96118

Hi Anne,

The quickest reference to find online is through your Local coverage determination.
http://www.trailblazerhealth.com/Tools/LCDs.aspx?ID=2870
Try and see if this helps answer your question.
Type in the CPT and it should give you some options to look at.
In case it doesn't, type in 90801. That will give you all codes that fall under mental health coding.

I'm trying to find an answer on how to use 97532 myself. I found it may be used by Psychologists. Mainly for OT and Speech Therapy. But what modalities fall under 97532?
I'm stuck...

Good Luck,

Barbara
 
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