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Coding for Autism services

  1. #1
    Location
    Madison Area Chapter in Madison WI
    Posts
    113
    Default Coding for Autism services
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    I am in Wisconsin where reimbursement for autism services will soon be mandated. I'm struggling to identify the behaviorial health services and appropriate coding for autism therapy.

    There are currently 16 or so other states that have autism mandates. If you have any experience with procedure coding for autism services, I would appreciate any insight you might be able to offer. Thanks so much
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  2. #2
    Default
    I have no autism experience, but I would think the CPT coding would be same as any other psych case. The problem I believe lies in the DX and whether it will be paid or not, correct?
    I am also in WI, but do not do anything with autistic children.

  3. #3
    Location
    Madison Area Chapter in Madison WI
    Posts
    113
    Default
    I'm trying to identify what behavioral health treatments are used for autism. Once I identify what is provided, I can find the codes. Thanks for you reply.
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  4. #4
    Red face Coding for Autism
    Claudia,
    I am auditing SBHS. Some of the autistic children are receiving speech therapy for their autism spectrum disorder. They may receive OT services as well. Hope that helps.
    Willie

  5. #5
    Location
    Madison Area Chapter in Madison WI
    Posts
    113
    Default
    I'm trying to identify the specific behavioral services. The most I've been able to learn is that "play therapy" is used. I'd really like to know more information on the actual service that is provided.

    The non behavioral (eg speech) seem to be pretty straightforward, but the behavioral therapies are more vague. I'm hoping some one who does provides or codes for behaviorial therapies will be able to help. Thanks.
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  6. #6
    Location
    Jacksonville River City FL
    Posts
    22
    Default
    I am in Florida and my providers, both MD and PhD, treat numerous patients with autism spectrum disorders. We provide group psychotherapy as well as individual, and also medication management. Most payors have begun to cover autism diagnoses in the past couple years.

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