Wiki T1015 and E&M codes

[lcourt6]

Hi all,

Curious if anyone knows the proper billing guidelines for T1015 and E&Ms? I work with many FQHCs as part of a Medicaid ACO. Many of our health centers seem to have very high usage of T1015 but without an associated E&M. Is there a guideline for billing that someone could point me to? I only have an ICD10 code set book.

Thanks!!

 

[rcj0401]

I would use the state's MCD manual. I work for an FQHC. The doctor's code but we are responsible for turning that coding into the "language" the payer wants. (i.e., the difference in billing and coding). We are in Arkansas and our claims go with T1015 being the equivalent of the E&M. Part of the manual will have what is FQHC services and what is not.