Medical Billing Forum
Billing => Billing => : cbergeron September 18, 2009, 11:53:52 AM
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I have been searching for the true definition for 92506 and 92507. New Hampshire Medicaid states them as 15 minute codes. I looked on CMS website and it does not state a time. Can someone please tell me if Medicare will pay for 4 15 minute units? The CMS fee schedule says $23.80 for payment which seems like a 15 minute payment for service.
HELP! I dont want to go to jail because I billed 4 units instead of 1. I dont look good in orange.
Thanks!!
Chris
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I'm assuming you mean same day?
Here's what I found, not sure this helps
Q: Can I bill for an evaluation and treatment on the same day? In other words, can I bill CPT 92506 and CPT 92507 on the same day?
CMS has coding edits called the National Correct Coding Initiative (CCI) and it allows the use of these two codes on the same day when two distinct services are provided. You would not bill these two codes once treatment has started, even though you are continually evaluating the patient's functional level.
If the patient requires a complete re-evaluation due to a significant change in the patient's overall condition, and the visit only encompasses that service, you could bill CPT 92506 alone.
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HELP! I dont want to go to jail because I billed 4 units instead of 1. I dont look good in orange.
Thanks!!
Chris
Good to see you being job conscious. Orange is my favorite color, but I agree with you on this!!
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This web site may help:
http://www.lsha.org/2008files/ASHA-%20Timed%20+%20Untimed%20CPT%20codes%20.pdf
Michele