Medical Billing Forum

Billing => Billing => Topic started by: rdmoore2003 on February 22, 2011, 01:37:12 PM

Title: mental health
Post by: rdmoore2003 on February 22, 2011, 01:37:12 PM
which is better when it comes to psychological testing billing?
ex:  mmpi = 2units-96101
       mbmd = 1 unit-96101
       mcmi = 1 unit-96101

or

96101= 4units
Title: Re: mental health
Post by: Michele on February 23, 2011, 07:26:28 AM
We have always seen it billed 96101 4 units, but I'm curious to see if anyone else has done it the other way.

Michele
Title: Re: mental health
Post by: rdmoore2003 on February 23, 2011, 08:25:23 AM
We have an insurance that wants us to submit per test individually.   It is the most bizarre!!!!!!
Title: Re: mental health
Post by: rdmoore2003 on February 25, 2011, 02:33:34 PM
Is anyone having issues with insurances paying, other than medicare, if in group?
90801- contracted LPC
96102- contracted Medical Psychologist
Title: Re: mental health
Post by: Michele on February 26, 2011, 08:33:45 AM
There are some commercial carriers that do not reimburse for services by an LPC.  As for the 96102, I would contact the carrier, maybe they don't have the psychologist contracted as able to do psychological testing.  It may just be the way they have them input into their system.

Michele
Title: Re: mental health
Post by: rdmoore2003 on February 28, 2011, 11:58:38 AM
thanks michele
Title: Re: mental health
Post by: rdmoore2003 on March 08, 2011, 12:24:03 PM
if doing psych. testing....can you bill insurance with the date of the report or the actual dates the tests are given.

ex:  if test is given on 2/25/11 but report is done and dated 3/16/11 ---can I bill for 3/16/11 instead of 2/25/11?
Title: Re: mental health
Post by: Michele on March 09, 2011, 07:53:59 AM
I believe you are supposed to use the date the testing was done.
Title: Re: mental health
Post by: rdmoore2003 on March 15, 2011, 09:09:31 AM
Where could I find this information.  I know that these codes (96101 & 96102) include report writing time and therefore that is why my question is if we can file using report date. On the report, administration dates are listed.  We are trying to figure out a way to have patients do all of their testing in one day instead of having to come back over and over, especially for those that are coming a long distance and pain patients that cannot sit for long periods.  Please help!!!!!
Title: Re: mental health
Post by: PMRNC on March 15, 2011, 01:30:13 PM
I don't know you would find anything.. charges should always be billed according to the date of "service" Service being the date the test was performed.
Title: Re: mental health
Post by: rdmoore2003 on March 15, 2011, 02:03:37 PM
I agree.   Where can I go to get "proof" of billing for dates of service only.    To me it is common sense and never thought I would have to get this information.  I know that you guys hate this when a provider tries to pull this, but we are not out sourced.  I have to have something backing this up.
Title: Re: mental health
Post by: PMRNC on March 15, 2011, 07:23:09 PM
Open up any insurance policy book, it's in there, Go to Medicare's website it's in there too. It will tell you "date services rendered"  I'm not understanding why you need to back this up? 

Quote
if test is given on 2/25/11 but report is done and dated 3/16/11 ---can I bill for 3/16/11 instead of 2/25/11?

I'm confused as to why the provider needs to back this information up as it is just sort of common sense, what do they think they would be losing?
Title: Re: mental health
Post by: rdmoore2003 on March 17, 2011, 03:07:24 PM
it all comes back to another provider telling him "stories"     I am not outsourced and cannot afford to lose my job.   BUT I REFUSE TO DO ANYTHING ILLEGAL KNOWINGLY.
Title: Re: mental health
Post by: rdmoore2003 on March 17, 2011, 03:13:00 PM
billing 101  (common sense)   anything billed must use the actual date of service.  everywhere i look i cannot find this printed, (because it is common sense 101).   if i cant give him this information in writing, i will not have a job.......
Title: Re: mental health
Post by: Michele on March 18, 2011, 08:09:55 AM
You are in a tough position.  Why don't you try contacting a provider rep for one of your larger insurance carriers and ask them.  Also, ask them for anything written on the topic.  Maybe if you get it from the insurance carrier how they require it billed, he will listen to that.

Title: Re: mental health
Post by: pattil88 on March 18, 2011, 09:43:42 AM
Maybe this will help - this article deals w/psychological testing and date of service:

https://questions.cms.hhs.gov/app/answers/detail/a_id/9182
Title: Re: mental health
Post by: rdmoore2003 on March 18, 2011, 11:40:18 AM
I was able to find this on cms website:

The psycholoist is expected to bill for the work he/she performed on that date of service.  If all of the testing is conducted by a psychologist, then the professional code should be billed for the time spent on test administration, interpretation and report preparation, as well as integration of previously interpreted test results into a comprehensive report ( 96101)

Only the appropriate technician administered or computer administerd codes can be billed on the actual date of service if a psychologist interprets and writes a report on individual tests administered by a technician (96102) or computer (96103).  The interpretation and reporting of the individual test results by the psychologist which may sometimes occur on a different date than the testing date are already captured in the payment for the technician and computer-administered codes.

I also found this with bc and magellan etc.   Is the interpretation that since he does the report on a different day for 96101, that it can be billed as date of report????
Title: Re: mental health
Post by: PMRNC on March 19, 2011, 10:15:15 AM
Quote
I was able to find this on cms website:

The psycholoist is expected to bill for the work he/she performed on that date of service.  If all of the testing is conducted by a psychologist, then the professional code should be billed for the time spent on test administration, interpretation and report preparation, as well as integration of previously interpreted test results into a comprehensive report ( 96101)

Only the appropriate technician administered or computer administerd codes can be billed on the actual date of service if a psychologist interprets and writes a report on individual tests administered by a technician (96102) or computer (96103).  The interpretation and reporting of the individual test results by the psychologist which may sometimes occur on a different date than the testing date are already captured in the payment for the technician and computer-administered codes.

I also found this with bc and magellan etc.   Is the interpretation that since he does the report on a different day for 96101, that it can be billed as date of report?Huh

No, what it means is that if the report was done separately on another day it was already captured in the pmt for the administered code on the testing date.