# Request input on use of 91000



## rmstapleton (May 3, 2013)

I am seeking input on the use of 91000 for outpatient facility claims in 2012.  Is there a reason why this code is still being used when it was deleted in 2011?  Thank you.


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## mitchellde (May 3, 2013)

It should not have been and should not have been paid.  The only payer that may still use a deleted code is work comp otherwise it is not compliant to use a deleted code.


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## rmstapleton (May 3, 2013)

Thank you Debra.  Is it possible that 91000 is uniquely payable under a self funded benefit plan?  My concern is that the TPA's I have been involved with follow the CPT guidelines closely and yet I am seeing billed charges and payment for this code.


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## mitchellde (May 3, 2013)

If they are a non HIPAA payer then it is possible. If they are a HIPAA regulated payer then no


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