Q&A

Can you bill for more than one CPT code?

Can you bill for more than one CPT code?

A session with multiple CPT codes will still appear as a single session in your schedule. This is because each service line on the CMS-1500 is for a single CPT code. The insurance company also pays you individually for each CPT code.

Can 36415 be billed twice?

Billing and Coding Guidelines CPT 36415 is only eligible to be billed once, even when multiple specimens are drawn or when multiple sites are accessed in order to obtain an adequate specimen size for the desired test(s).

Can you Bill 2 ER Visits same day?

Can a provider bill for two emergency room visits on the same day for the same patient? If the second ER visit is essentially for the same reason as the first, the hospital cannot bill for it. If the second visit is for a different reason, the hospital can bill for the visit.

What is the bilateral procedure rule?

Definition: A surgical procedure is considered bilateral when the same procedure is performed on both sides of the body. Bilateral surgical procedure codes must appear on two separate claim lines.

How do I get paid for CPT 99000?

Guru. For the 99000 code, the only way for this to pay is if the laboratory service is not performed in the provider’s office and the independent laboratory is going to bill the insurance directly for the test.

How do I know if a CPT code is bilateral?

If the code has an indicator of two, it is a bilateral procedure code. You would not need to add a modifier 50 because the code is already bilateral. A code with this indicator lets the insurance company know that both sides were done. Claims will be processed at 100% of the allowable.

Can a therapist Bill two CPT codes at the same time?

In the same 15-minute (or other) time period, a therapist cannot bill any of the following pairs of CPT codes for outpatient therapy services provided to the same, or to different patients. Examples include: Any two CPT codes for “therapeutic procedures” requiring direct one-on-one patient contact (CPT codes 97110-97542);

Can You billing for one on one and group therapy?

Billing for both individual (one-on-one) and group services provided to the same patient in the same day: This is allowed, provided the CPT and CMS rules for one-on-one and group therapy are both

What are the Medicare codes for two visits?

I billed the following codes: 99308, G0467, 90834, G0470 with no modifiers on the same claim – not separate claims and was paid by Medicare by both visits.

What is the Medicare one on one CPT code?

The group therapy CPT code (97150) and the direct one-on-one 15-minute CPT Codes for therapeutic procedures (97110 – 97542) are subject to Medicare’s National Correct Coding Initiative (NCCI). The NCCI edits require the group therapy and the one-on-one therapy to occur