Medical Billing Forum
Billing => Billing => : rdmoore2003 July 07, 2011, 12:51:43 PM
-
Is there a code or codes that can be used for emergency or after hours treatment in mental health? Our insurance contracts all show our office hours during the week. We have recently had a number of emergencies after hours and weekends. I know there are medical office codes that can be used for situations like these, but I am not aware of codes for mental health. Any help on this???
-
You could try adding on the 9905* codes but I don't think most insurances will allow it.
-
9905? What is this?
-
99050, 99051, 99053 depending on which is applicable.
-
i will definitely look into. thank you.
-
when it comes to Tricare insurance. We have a pt that needs to do extensive individual therapy for ptsd, a ptsd group, and medication management. the group and med visit is by 1 provider but the individual therapy is a different provider in the office. (group practice under same tax id) instead of the patient coming in 3 times a week, how could i code to get reimbursed, if say pt comes in 1 or 2 a week instead of 3?
-
I was waiting to see if someone else had any experience with this. IMO the patient would have to come separate days for each service or else they will be denied. You could call Tricare to see if they would approve multiple services on the same day, but I'm not sure what they will do.
Good luck!
-
I have a couple questions on your tri-care is a member active-duty or dependent?
If the member is active duty, they have very different rules they have to follow then if it is a dependent.
Once you let me know if the active-duty dependent I'll be a will to help you further. I used to work for TRICARE in one of the military treatment facilities.
If they are active-duty and you’re putting them on meds. Make sure it does not jeopardize their duty status. I would make sure member is working with his local MTF office. You can send in a request to TRICARE requesting the MBR have a 90806 under one provider and 90805, 90853 under a different provider. Make you use the Tricare ref form.
What region are you in?
-
I have tricare and when I fill out forms I know that I have to put his SSN# because he is active duty and I am the dependent. The insurance portion ID # would be him but I do put my SSN there in the slot for the patient info. But all insurance coverage is always his (active duty) SSN#.
I am in tricare west region. Hope that helps even though its from the patients view.
-
I have tricare and when I fill out forms I know that I have to put his SSN# because he is active duty and I am the dependent. The insurance portion ID # would be him but I do put my SSN there in the slot for the patient info. But all insurance coverage is always his (active duty) SSN#.
I am in tricare west region. Hope that helps even though its from the patients view.
You are right with the ID # in a way. DEERS is no longer having the MBR's SS # on ID cards we now have a ID # has we need new ID cards they are giving us our new ID #.
But she is talking about office visit codeing.
The west region is the best. I love working with TRIWEST, they rock.
-
we are TricareSouth. the pt. is active duty and was referred by his supervisor. pt has been seen by our medical psychologist for medication and sees an lpc for extended therapy. now, they recommend that he also join a ptsd group. all has been authorized, but pt does have a bit of travel to get to us. since all are authorized, could we:
1. see him for his med check -90805 and ptsd group -90853 in the same day, same provider?
2. see him for his extensive individual therapy by lpc on different day.
I hope this makes sense.
-
I would run it by Tricare. Even though all services are authorized it doesn't mean they will allow them the same day. Explain that there is travel involved and you are doing it for the convenience of the active duty patient.
-
Active or non-active Tricare will not pay for more than one therapy code/visit per day.. period.
-
Thanks for clarifying, I didn't think so but I don't deal much with Tricare so I wasn't sure.
-
thanks Linda. I was just seeing if there was a way around it.
-
Wish there was, if there are NO other provider's in a certain distance you could call their case management team and ask how to go about setting up a review of procedure, but there has to be absolutely NO other provider's in that area for the patient to see.
-
yes I am aware of that. It would not work because there are other providers.
thanks again