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Med management and LPC same date of service

  1. #1
    Location
    Anchorage, Alaska
    Posts
    146
    Question Med management and LPC same date of service
    Medical Coding Books
    Does anyone have experience with billing for a Psychiatrist providing pharmaceutical managment on the same DOS as an LPC providing psychotherapy under the same TIN? The diagnoses are the same for both providers.

    In this instance, the MD wants to bill the appropriate level of E/M and the LPC wants to bill with appropriate psychotherapy code. However, payers are denying the LPC as bundled, even though they are billing under separate NPI's.

    So, our next thought was to bill the LPC "incident to" the MD, since the criteria is met for "incident to" using the approprite E/M service and the appropriate psychotherapy with E/M service add-on code.

    Thoughts?

    TYIA,
    Karen

  2. #2
    Default MD E/M with add on psych same day as LPC
    If anyone has a answer to this I would appreciate it. The MD is seeing the patient for medical management and billing 90833. The patient is then going to see the LPC different location for individual psychotherapy 90837????

    Isn't this considered "double dipping"?

    Thanks

  3. #3
    Location
    Anchorage, Alaska
    Posts
    146
    Default
    dtweedy;
    I see it as two totally different services, so I don't see how it can be double dipping. Med mgmt does not include psychotherapy. An LPC cannot do med mgmt.

    Karen

  4. #4
    Default
    Karen,

    The physician is billing the E/M code (med management) as well as the add on psychotherapy. The patient is then going the the LSW the same day for additonal psychotherapy.

    Dtweedy

  5. Default
    I would agree that if the MD is doing an E/M with the add on for Psychotherapy, this would be double dipping. We bill for med managment and counseling on the same day but not if the MD did the psycotherpay. If the MD is doing it, why does the patient need to see the LSW.

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