Results 1 to 3 of 3

Split Billing vs. Combining DOS 96116 96118

  1. #1
    Default Split Billing vs. Combining DOS 96116 96118
    Medical Coding Books

    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?

    Anne Tetzlaff, RHIA, CPMA, CCS-P, PCS, CPC, CFPC

  2. #2
    Please somebody answer this question, our facility is not clear on this also
    Thank you

  3. #3
    Default 96116 96118
    Hi Anne,

    The quickest reference to find online is through your Local coverage determination.
    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,

    The Oracle

Similar Threads

  1. How to Bill Psych Test Codes 96101, 96118 and 96116
    By tamstrnd in forum Billing/Reimbursement
    Replies: 2
    Last Post: 07-08-2015, 02:25 PM
  2. 96116 with 96118
    By RADCODER in forum Behavioral Health
    Replies: 2
    Last Post: 04-06-2014, 09:44 PM
  3. Coding and Billing for Psych Test Codes 96101,96118 and 96116
    By tamstrnd in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-03-2014, 08:01 AM
  4. 96116 and 96118: HELP
    By emillard in forum Behavioral Health
    Replies: 2
    Last Post: 06-11-2009, 06:16 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.