Medical Billing Forum

Coding => Coding => Topic started by: Angie on October 04, 2011, 07:29:34 AM

Title: Certified Coder
Post by: Angie on October 04, 2011, 07:29:34 AM

I was reading one of the posts in the coding and I had a question.
What if we do not bill the insurance company directly but just provide our patients with a superbill of the therapy sessions when they ask for one to seek reimbursement from their insurance. We do this in house and the therapist gives me the notes and I code it because it is always only the typical 90806, 90853, 90847 codes. Do I need to be a certified coder to code those notes?
Title: Re: Certified Coder
Post by: DMK on October 04, 2011, 11:01:42 AM
The therapist should be doing the diagnosing (ICD-9 codes) but as long as you know FOR SURE which code to use for the procedure and FOR SURE that the notes meet the criteria for the code you're using, you should be fine.  The patients will not get reimbursed if the dx and procedure codes aren't correct.  It is the therapist's responsibility to code things since THEY are the one's billing.  You and the therapist should be on the same page regarding how things should be coded and noted.
Title: Re: Certified Coder
Post by: Michele on October 05, 2011, 07:04:08 AM
With therapists there are very few codes.  Personally I would just go over it with the therapist initially stating that I would go by the time indicated on the notes to determine if it's a 90804, 90806 or 90808.  ALso, I would just verify that they do a 90801 on the first session with a patient.  Then you would not need to be a certified coder.  You are actually not coding it, you are following guidelines from the therapist and using the codes that they want used based on their notes.  DMK is correct, it is the therapist's responsibility so as long as they make it clear to you how they want it coded based on their notes, that would be fine.
Title: Re: Certified Coder
Post by: rdmoore2003 on October 06, 2011, 11:30:44 AM
EXACTLY