Medical Billing Forum

Coding => Coding => Topic started by: cogman1 on December 28, 2015, 10:05:08 AM

Title: neuropsychological testing/psychological testing highest level of specificity
Post by: cogman1 on December 28, 2015, 10:05:08 AM
Hello all,

I am a neuropsychologist who bills Medicare.  I was getting reimbursed for my testing using code 294.10.  Suddenly, my claims are being denied because they claim that I am not using codes to the highest level of specificity.  When I look up the definition of specificity, the information I read is the code is requiring a fourth or fifth digit.  Since the above code has these digits I am confused as to how to proceed.  Should I use a different code (the neurologist is concerned about verifying an organic dementia vs. depression or anxiety) to further explain the need for the service or some other strategy?

Thank you for any help.

Chris
Title: Re: neuropsychological testing/psychological testing highest level of specificity
Post by: kristin on December 28, 2015, 01:21:14 PM
Are these denials for claims with a date of service of 10/1/2015 and after? If so, the issue is you are using an ICD-9 diagnosis with the 294.10, and you need an ICD-10 code now instead.
Title: Re: neuropsychological testing/psychological testing highest level of specificity
Post by: RichardP on December 28, 2015, 02:19:04 PM
If you actually are still using ICD-09 codes and haven't converted to ICD-10, here are some links you might find useful:

http://www.icd10data.com/Convert
Converts ICD-09 to ICD-10

http://www.icd9data.com/2015/Volume1/default.htm
ICD-09 Codes.  Find the code you want in this list and it will have a link to the ICD-10 code(s).

http://www.icd10data.com/ICD10CM/Codes
ICD-10 Codes.
Title: Re: neuropsychological testing/psychological testing highest level of specificity
Post by: cogman1 on December 29, 2015, 02:15:28 PM
Thanks to both of you?

To both of you!!!  I will check the claims.  However, I do think some were prior to Oct 1, 2015.  I was wondering if CMS wanted more codes?  For example, a Parkinson code and the dementia unspecified code.  When I consult the LCD for neuropsychology the dementia unspecified code is supposed to be a covered service but offers no further guidance about how to actually code the patient.

I will recheck the claims.

Happy New Year

Chris
Title: Re: neuropsychological testing/psychological testing highest level of specificity
Post by: rdmoore2003 on January 06, 2016, 11:18:16 AM
The icd-10 code for 294.10 transfers to F02.80-  this would be for dates of service 10/1/15 and after.