Author Topic: Speech therapy billing  (Read 831 times)

Anne

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Speech therapy billing
« on: December 12, 2010, 07:08:23 PM »
I know that ST is not timed for CPT code 92507 - However, I've read that IF there are extenuating circumstances that more than 1 unit can be billed.   So, we have an extenuating circumstance for one of our patients.  This patient has Speech therapy with one therapist using 1 unit 92507 per date of service.   AND speech therapy for vital stim treatments with another speech therapist - I use 92526 for the V-stim (97032 was denied when I used that code).  The second therapist uses 92507 sometimes also, in addition to 92526 on the same DOS.   I've told them that ins. will deny if they use the same code on the same DOS (but they keep giving me charges using same codes same day). Both SLP's are with the same group under same Tax ID. 

 Patient has United Healthcare and I did a Care Notification prior to treatments;  they asked for documentation so I sent in the eval and letter of necessity from referring physician.  Care Notification was ok'd, so I put that number on claims of course, but should I be using a modifier also?  Should I send in progress notes with each claim and do paper claims?  (there is not a way to attach documentation with my electronic billing service).    I've explained that ST is not timed but they would like to be reimbursed for all services - but reimbursement is for only 1 unit - if treated for 15 mins or hr and a half.  I think I'm doing something wrong.

Michele

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Re: Speech therapy billing
« Reply #1 on: December 13, 2010, 11:42:26 AM »
Have you tried talking to United Healthcare and explaining this patient's situation?  They may have a way that they want you to bill to indicate the services, or they may be able to inform you of a way to appeal with documentation so that they can review the case individually.

Michele
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