Author Topic: psychological testing  (Read 2435 times)

rdmoore2003

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psychological testing
« on: November 13, 2009, 08:09:42 AM »
my providers do a 3 step process for psych evals.  intake, psych testing, feedback.    Typically, clients do not get to do psych testing on the same day as an intake due to non payment from insurance companies for these procedures done in the same day.  I need help!  There has to be an easier way.
Ex.   DOS:  11/1/09   CPT 90801
        DOS:   11/2/09   CPT 96101
         DOS:   11/2/09   CPT  96102
DEPENDING ON INSURANCE COMPANY,  THESE TESTS CANNOT BE DONE IN THE SAME DAY AS INTAKE.  CAN ANYONE HELP?  DO I USE MODIFIER -25 ON THE 90801?
Regina

PMRNC

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Re: psychological testing
« Reply #1 on: November 13, 2009, 11:29:40 AM »
Not sure what you are asking, you don't need a modifier because you are not billing the 90901 on same day right? Or is the provider providing the testing on the same day and you are billing it for different day? I hope not, as that would be fraud.
Linda Walker
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MBP

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Re: psychological testing
« Reply #2 on: November 13, 2009, 11:59:37 AM »
if this was done one the same day you could use mod for multiple procedures maybe, but that would lower the payment. i use mod 25 for office visit when there is a procedure done in the office on the same day. but i bill office visits using E&M cpt (99***), i have no idea how does it work with psychologists. e.g. office visit exam + office breast biopsy, i put 25 on cpt for that office visit and bill it together with the biopsy as initial visit was thorough examination itself.

PMRNC

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Re: psychological testing
« Reply #3 on: November 13, 2009, 12:18:58 PM »
The way I read her example, the 90801 was done on 11/1 by itself so wouldn't need a modifier. The testing was the following day (diff claim).  The provider should not be doing the testing on the same day carriers will not pay for it. And you can't do it all on one day but bill the carriers because that is fraud. When benefits are verified and the auth is received the client then can make the necessary appointments and bill the intake on one day and the testing on another.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

rdmoore2003

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Re: psychological testing
« Reply #4 on: November 13, 2009, 02:21:42 PM »
just to verify---my question was:  can psychological testing be done the same day as an intake (90801 & 96101)?  If so, modifier -25 on 90801?  I was just wondering if there was a simpler way to file the claim for these procedures instead of having to drag out the 3 step process.   We see alot of pain management clients and some live a ways away.  Just trying to help my clients and help my providers with the steady income without bundling or having clients miss out.   sorry for any confusion.
Regina

rdmoore2003

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Re: psychological testing
« Reply #5 on: November 13, 2009, 02:24:28 PM »
thanks erika--i understand your concept.   I use the -25 modifier when numerous psych testing is done in one day.   I just wondered if there was a way to do the intake and at least start the psych testing in the same day.   Depending on the client and dx, there could be anywhere from 2 tests to 10 tests ordered.   
Regina

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Re: psychological testing
« Reply #6 on: November 13, 2009, 04:46:36 PM »
Quote
can psychological testing be done the same day as an intake (90801 & 96101)?

No, they have to be done on different days. I've not come across a mental health provider who would WANT to do it on same day, let alone the patient.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com