Coding > Coding
2011 CPT codes for Medicare
Leslie Bartley:
Our clients stay from 9:00 am to 1:30 pm (M-F). They are provided with transportation, a snack and lunch; in addition to four services. As we are just beginning to bill we didn't know about a room and board cost. What CPT code would that come under?
Blessings,
Leslie E. Bartley, Ph.D.
Michele:
I don't think that would qualify for room & board. There is no cpt for room and board, just rev codes. I am not familiar with billing for services such as this. I'm thinking that you will only be able to bill for the individual services that are provided. I'm not aware of any codes to use for what you've described. There are psychological testing codes that may apply. The following may be quite helpful:
https://www.cms.gov/transmittals/downloads/R765HO.pdf
Leslie Bartley:
Michele,
Thanks you for all the advise you have given about coding for Medicare. I believe we are set to send in, electronically, our first billings. This has been a year long journey. Without your help and patience we could not have come this far. After weeks, our CPT coding book arrived yesterday.
Your eBooks are great and I recommend them to anyone that is beginning the medical billing journey.
Blessing,
Leslie E. Bartley, Ph.D.
Leslie Bartley:
Michele,
What is the difference between 90801 and a 96150? I'm trying to figure out how to code and bill the following sequence:
1. Day One: Client and our nurse obtain & record intake data on the client (name, address, phone, email, contact person, social security number, medicare number, discuss client's complaint, etc.)
2. Day Two: Our social worker administers three test.
3. Day Three: Our Psychiatrist reviews client's file and conducts a diagnostic interview with the client. Our social worker is also consulted in the process. The Psychiatrist evaluates and makes a formal diagnostic.
4. Day Four: Our Social worker develops a Master Treatment Plan in keeping with the Psychiatrist's diagnostic goals and objectives.
5. Day Five: The Psychiatrist reviews the Master Treatment Plan, makes any additions, and signs off.
6. Day Six: Admitted client begins the daily program designed for the client.
7. In 30 days the client is re-certified (Recert) and every 30 days until the client is discharged.
Any help would be greatly appreciated.
Michele:
96150-96151 are reported assessment of psychological, behavioral, emotional, cognitive, and relevant social factors that can help to prevent, treat, or manage physical health problems. The assessment must be associated with an acute or chronic illness, the prevention of a physical illness or disability, and the maintenance of health. The initial assessment (96150) and re-assessment (96151) apply to each 15-minute direct, face-to-face session with the patient. A reassessment (96151) is reported to obtain objective measures of goals formulated in the initial assessment and to modify plans as is indicated to support the goals.
This web page also has a lot of info on this: http://www.priorityhealth.com/provider/manual/auths/~/media/documents/medical-policies/91546.ashx
90801 is a Psychiatric diagnostic interview examination.
You may also want to look at codes 96100 - 96117.
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