The facility fee and professional fee for the inpatient side really have nothing to do with one another. Perhaps you need to explain that to your carrier.
96116 & 96118 represent physician (Pro fee) codes; 96119 represents a facility fee (not appropriate for IP) and I really would need to research the use of 96120. -26 Mod is inappropriate on 96120, making it unclear what appropriate use would be
I hope this offers you some assistance.
I would also think that unless your providers are credentialed with the payer as psychiatrists or neuro, it may be unlikely the carrier will recognize the use of these codes from them--though that's just a thought.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join