Medical Billing Forum

General Category => General Questions => : surfergirl September 11, 2016, 03:39:06 PM

: CPT 90785 for 2019 UPDATE
: surfergirl September 11, 2016, 03:39:06 PM

Hello Forum,
As a mental health biller I am having difficulty getting Blue Cross to pay 90785 with or without an attached modifier with the primary CPT ( ie 90847).
UBH,  Cigna and other carriers pays this code (not by much).

My question is has anyone been successful with getting payment from Blue Cross with this code and if so what is your secret please.

UPDATE
Hello again fellow billers.
I meant to say 90785 can be billed with a 90834. Cigna, and UBH does pay a little without any modifier. Now Federal Blue Cross is paying $11.09 as of January 2019 with no modifier. Reg Blue cross still is not. Why the discrepancy. Should I now try again to bill with a modifier for Blue Cross. The allowed amount is $11.12. And should put -25 on the 90834.

Thoughts please.
Many thanks.
Surfergirl

: Re: CPT 90785
: Michele September 11, 2016, 08:30:32 PM

I am not a certified coder but I believe the 90785 is an add on for 90791 or 90792.  The 90847 is probably the problem. 

: Re: CPT 90785
: Sriram_Sub September 13, 2016, 08:40:01 AM

Hi Surfergirl,
Please check this link. It states that 90785 may not be billed with 90847.

https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0ahUKEwjHgOK-j4zPAhUCz2MKHVkxBYsQFggwMAQ&url=https%3A%2F%2Fwww.aacap.org%2FApp_Themes%2FAACAP%2Fdocs%2Fclinical_practice_center%2Fbusiness_of_practice%2Fcpt%2FInteractive_Complexity_Guide_2012.pdf&usg=AFQjCNGJmNeLiqFbhxqBkmeiSC0MODW94g

Regards
Sriram