NAMAS Webinar Q&A: Specialty Auditing: Implementation of Mental Health Services... 03/24/2020

Post here your questions regarding auditing ,coding, documentation, and compliance. Also, join in on the conversation- help your fellow auditors and compliance professionals in the industry.

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Tue Mar 24, 2020 4:25 pm

Below are the questions received during our recent webinar, Specialty Auditing: Implementation of Mental Health Services Into Primary Care and Pediatric Practices, originally presented on March 24, 2020. These questions have been answered by the webinar presenter, Stephanie Allard, CPC, CEMA, RHIT

Question 1:
Can be dyslexia testing be billed with the psych testing codes?
Answer 1:
This is going to first depend on the payer, some do consider testing for dyslexia to be experimental/investigational. Secondly, it will depend on the test that is administered. Do you know the name of the testing that they will perform? It may fall into the vision testing category, but overall if the payer does not find it medically necessary they will not reimburse.

Question 2:
Can you bill a 90791 with a 96132/96133 or does the 96116 need to be billed?
Answer 2:
The CPT code 96116 is considered to be bundled and never billable with 90791, so you will not be able to bill for 96116 if it is performed on the same date as the diagnostic evaluation 90791.

If the provider performs Neuropsychological testing (96132/96133) on the same date as a diagnostic evaluation they would both be billable as no NCCI edit exists.

Question 3:
Does start and stop time have to be documented or documented total time will be enough i.e psychotherapy for 30 min 90833?
Answer 3:
This is going to depend on your Medicare Carrier (MAC) for your state. Some of the MAC's, Novitas for example, do require start and stop times. If you are unsure if your MAC requires it, it is best to have it documented.

Question 4:
When billing G2012 which POS do we use 02, 11 or 12? I can’t seem to find anything in writing.
Answer 4:
The code G2012 is not on the CMS list of telehealth codes and their guidance to use POS 02 is directed at telehealth services. I would use the typical POS 11 if they are providers from an outpatient clinic.
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