OT 97165 and 96111

[June Lawrenz]

I am not a coder ~ that being said, I bill for a clinic that is both Speech and Occupational Therapy. After submitting 96111 + 97165-59, the clearinghouse kicked the claims back stating 96111 has been deleted. We've located an article via ASHA that discusses code replacements, but don't know if these work for OT as well. Does anyone have any knowledge of the proper coding to define extending testing for OT?

[Michele]

I am not seeing any new codes specifically for OT testing other than 96110. 

[June Lawrenz]

96111 was deleted as of January 1st, and replaced with 96112 and 96113. Are we still allowed to bill them along with 97165/97166/97167?

[Michele]

If both (or all) services were done then they can be billed together, but each individual insurance carrier will determine if they allow those codes at the same session.  There is no one answer for all insurances.  They may require a modifier to indicate they were separate services.