• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Billing for managed care services

Create Wiki
K

kimberagame

Networker
Messages
27
Location
CORVALLIS, OR
Best answers
0
Our clinic's case management team routinely goes to visit patients and their families in SNFs to come up with a care plan. The head of managed care would like to start billing for this and I'm looking for a CPT code that this would fall under. The closest I'm seeing is 99366. Does "nonphysician qualified health care professional" mean an actual provider who's just not a physician? Or would a case manager count? The requirement for a separate E/M could be met with 99490 and it's very possible that some of these visits include a multidisciplinary team (I'd have to check to know for sure). If so, the requirements would all be met. But when I read about the code online, I get the impression that it's for nonphysician provider time only. Does anyone know for sure? Or is there a different code you guys use for this? Thanks for any input!
 
Actually, I just realized that 99490 would not qualify, as it's not a face to face E/M. I'm still curious if this is limited to nonphysician providers, though, or if case managers would qualify.
 
You must log in or register to reply here.
Top