Author Topic: Mental Health- Auto Claim and place of service code.  (Read 779 times)

sandier

  • Newbie
  • *
  • Posts: 2
Mental Health- Auto Claim and place of service code.
« on: June 22, 2010, 04:17:02 PM »
I bill for an a outpatient behavioral health clinic.  A current pt. has filed an auto claim due to a hit and run accident.  Because of the accident, he is incapaticitated and unable to leave his home.  His therapist will be going to his home for his therapy sessions.  I am stumped as to how to bill these sessions as I have never come upon this situation.
Do I bill the appropriate procedure code (90806) with a 12 (home) place of service code?  He has a coordinated policy and I am aware that his health insurance will not reimburse for this place of service code.  However I will need to bill them for the rejection and bill auto as secondary.  If anyone could help me out with this, I sure would appreciate it.
thank you in advance! 

Pay_My_Claims

  • Guest
Re: Mental Health- Auto Claim and place of service code.
« Reply #1 on: June 22, 2010, 06:37:57 PM »
is his mental health issues related to his auto accident??? If not it has NOTHING to do with the claim.  you can bill 90806 with service code 12 and it will pay

Place of Service
The table below matches the procedure code to the acceptable place of service:
Code Range Acceptable Place of Service (Code)
90804-90815
Office (11)
Home (12)
Outpatient Facility (22)
Emergency Room-Hospital (23)
Custodial Care Facility (33)

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4706
    • Solutions Medical Billing
Re: Mental Health- Auto Claim and place of service code.
« Reply #2 on: June 23, 2010, 08:47:04 PM »
I've actually seen similar.  Yes, the services are related to the auto accident.  It is because of the auto accident that the patient is needing the therapy.  It is billed as you said, with the appropriate cpt code, but a 12 for the place of service.

Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com