Author Topic: codes w/ medicare  (Read 1890 times)

rdmoore2003

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codes w/ medicare
« on: March 07, 2011, 11:10:18 AM »
Will medicare pay for a 90801 & 96102 together in same day?  If so, will they require a modifier?
Regina

PMRNC

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Re: codes w/ medicare
« Reply #1 on: March 07, 2011, 05:47:08 PM »
It really would not surprise me if you are asked for notes, it isn't normal to do the initial eval on same day as the testing. If the doctor is going to try and bill the eval at same time, they most likely will not pay for it, since interpretation/scoring is included with the 96102 and they will question the reasoning behind the 90801... ALSO.. something else to consider.. the testing won't be limited by the mental health psych pmt limitation..so why would he do the eval on same day? 
Linda Walker
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rdmoore2003

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Re: codes w/ medicare
« Reply #2 on: March 08, 2011, 09:39:23 AM »
Dont laugh......he has spoken with a friend that is also a M.P.    His friend is filling his head with all kinds of things.   Now, his friend is considered a facility because the hospital does all of his billing.......long story short,  friend tells my provider that he bills a 90801 & 96102 in the same day, no modifiers and gets paid.   Also that when friend does the actual report, he uses the date of the report to file for testing instead of the actual dates the tests were done.  I am not concerned on sending notes to medicare.   last year medicare required notes from say 10 mental health providers here in our area, and we were the only provider that "passed" with our documentation.
I understand my provider is trying to get more streamed line with income and because we see people from all over our state and even have people coming from out of state.
I am however a bit afraid to try all of these different ways of billing....my red flags are flying high......  this is how I bill-  pt comes in for intake , I bill 90801   from that intake they decide if/any tests that will be done.   We schedule the patient to come back in for testing, with medicare I know they do not allow 96101 & 96102 in same day.  So, for p/p testing patient comes in and completes and for 96102 testing it is scheduled with testing tech.   once all testing is complete, the have feedback with MP.
Regina

Michele

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Re: codes w/ medicare
« Reply #3 on: March 09, 2011, 07:53:03 AM »
I hate when a provider starts a sentence with "My friend told me .....".  My other favorite is "I went to a seminar this weekend....."

UGGHHHHH!
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PMRNC

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Re: codes w/ medicare
« Reply #4 on: March 09, 2011, 10:04:50 AM »
Quote
I hate when a provider starts a sentence with "My friend told me .....".  My other favorite is "I went to a seminar this weekend....."

MY absolute favorite starts like this :  My wife thinks....      LMAO.......... to which I then begin my response : You then tell your wife....

LOL 

I actually keep a notebook (5 subj one) that has notes in it just for my own reference ... AND laughs.  It's so full I KNOW I could write a book!!
Linda Walker
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DMK

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Re: codes w/ medicare
« Reply #5 on: March 09, 2011, 01:11:41 PM »
My favorite is "I read on the internet...."    :-\

PMRNC

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Re: codes w/ medicare
« Reply #6 on: March 09, 2011, 06:17:12 PM »
Quote
My favorite is "I read on the internet...."    Undecided

OH good one!!  I'm very super duper lucky.. my clients are NOT friends of the computer at all!  I have one that absolutely refuses to even LOOK at the computer. He cannot log on, or anything.. LOVE IT :)
Linda Walker
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