Author Topic: Billing 3 separate visits on the same DOS - denied!  (Read 1179 times)

mhprovider2

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Billing 3 separate visits on the same DOS - denied!
« on: July 14, 2015, 06:15:24 PM »
Hi, I'm trying to bill for 3 separate psychotherapy services for one patient on one DOS:

90791
90846
90834

Each were at separate times (which I know isn't able to be marked on a HCFA!) by a licensed psychologist (so not an MD, no medication-related services).

90791 was accepted, but the other 2 claims came back as denied, with error messages stating that the codes have a unbundled relationship with one another.

All 3 services were medically necessary.

The insurance company didn't know what to tell me, other than I could try to add "modifiers."  This is all new to me, and I can't figure out what modifiers to use.

Anyone have any suggestions?

Thanks in advance!

PMRNC

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Re: Billing 3 separate visits on the same DOS - denied!
« Reply #1 on: July 15, 2015, 09:14:58 AM »
I would say your not going to get paid by any carrier for these all on one date.  What was reason for all three visits in one day?
I can't even say what modifier as I don't think one would even be appropriate.

The 90791 is the Interview
then 90846 is group/family w/out patient
90834 is the psychotherapy session individual.

It seems like the carrier processed claim correctly because the other two are on same day, the visits should have been on different days. Did you need / obtain authorization?
Linda Walker
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djk

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Re: Billing 3 separate visits on the same DOS - denied!
« Reply #2 on: August 04, 2015, 10:20:45 AM »
what insurance are you billing to..  Medicare you can try modifer 59 separate procedures..

rdmoore2003

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Re: Billing 3 separate visits on the same DOS - denied!
« Reply #3 on: August 04, 2015, 02:10:40 PM »
I do not think you will get paid for this as these services typically cannot be done in the same day.  I have never heard of anyone doing this anyway.  You may want to re-read the definitions of these codes.
Regina