Medical Billing Forum
Coding => Coding => : jessika1803 March 05, 2013, 03:45:31 PM
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ok so I'm having an issue with billing a 90853 for 3 units (30 minutes per unit) to blue cross. what is did before was bill the 90853 with a quantity of 3. Now they're saying I'm not billing it right to get paid for the 3 units. Can anyone help me? This is for Mental Health billed on a HCFA 1500. Thanks
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What are the 3 units for? Dates of service? Are you breaking out the dates of service? 90853 is not time dependent, the carrier will only pay fee schedule based on that CPT for par or U&C for non par. You can only bill ONE unit of 90853 per DOS
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i have info that each unit is 30 minutes. and its a 90 minutes group therapy session. I billed like this before and received payment. 2013 its suddenly changed and Blue Cross even told me I was missing info for it to be paid that way
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I don't know what to tell you. 90853 IS not based on time. Official CPT description is: GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP) It is NOT time dependent. Carriers you par with will have ONE fee schedule for ONE date of service per 90853.
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ok so I'm having an issue with billing a 90853 for 3 units (30 minutes per unit) to blue cross. what is did before was bill the 90853 with a quantity of 3. Now they're saying I'm not billing it right to get paid for the 3 units. Can anyone help me? This is for Mental Health billed on a HCFA 1500. Thanks
Dont be surprised when blue cross recoups the money if they infact paid per unit on the group code. Linda is correct, 90853 is not a time dependent code.