Medical Billing Forum

Coding => Coding => : Cpatel May 17, 2019, 03:00:12 PM

: E/M service and Therapy service on same day
: Cpatel May 17, 2019, 03:00:12 PM
Hello,

For Psychiatric practice, when patient is seen by NP for medication management or E/M and for therapy by LCSW on same day, codes are billed 99211 to 99215 (25 mod)for NP and therapy codes (90833 or 90836 or 90838) for LCSW. Per payer's requirements we have to send E/M and therapy add on code on the same claim. In this case I noticed that system is sending out both the CPT codes (E/m & therapy) on same claim but under NP's NPI as rendering (24J). I want to know whether it is appropriate or not? If not then any suggestions would be appreciated.

Thank you

 
: Re: E/M service and Therapy service on same day
: Michele May 17, 2019, 04:37:54 PM
Since the services are being done by different rendering providers they should go on separate claims so that each rendering provider can appropriately be identified on the claim.
: Re: E/M service and Therapy service on same day
: PMRNC May 22, 2019, 10:49:11 AM
IF one of the providers is ONLY doing Med mgmt use M0064 for med check. As Michele said, if they are different providers they should go on seperate claims. SOME carriers won't pay however for both on same day unless it's the provider billing E/M with psychotherapy add on codes.
: Re: E/M service and Therapy service on same day
: Cpatel May 22, 2019, 05:15:15 PM
Thank you Michelle and PMRNC.