Wiki Audiology OV?

[JlHoeftcpc]

I'm new to Audiology billing field. My physicians want to know when & with what Ins companies they can bill for an OV? I know their documentation has to support it. But with their limited services rendered, I'm not sure what's bundled? Any help appreciated! Thanks, JH

 

[sbicknell]

I guess I am just more familiar with Audiologists coding CPT in the 925xx range for their services.

If he documents the required components to meets an 99201-99215 E&M code, then he can code and bill. But not to Medicare and maybe not to other payers.

Q: Can an audiologist ever bill evaluation and management CPT (Current Procedural Terminology, ©American Medical Association) codes such as 99244, 99201, or 99215?

Audiologists cannot bill Medicare for evaluation and management services (i.e., office visits). Some private health plans allow audiologists to use these codes. You should check with the private health plan before submitting a bill

If he wants to code/bill E&M, I would call your top 5-10 payers and verify their reimbursement guidelines. He would have to look at the 1997 E&M exam guidlines for either General exam or ENT exam and see if he provides that extent of service.

Here is the link for the above paste and provides some really good info
http://www.asha.org/Publications/leader/2010/100608/Coding-Reimbursement.htm


Here is a link to a superbill that is out there online. It might help you with some of the audiology codes
http://www.asha.org/uploadedFiles/ModelSuperbillAud.pdf