Wiki Help please 90837 with dx 309.81 being denied by Humana

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samilne

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My billing department has submitted a claim for 90837 with dx 309.81 to Humana (dos 07/31/15). It was rejected, reason being dx309.81 is not a supported dx for cpt 90837. We submitted the medical record to Humana and it was again rejected, reason being the notes did not support the dx with the service billed. What can we do? Is 309.81 not a supported dx for cpt 90837?? Any help is appreciated.

Thank you.

Susan M
 
Post traumatic stress disorder needs the documentation (and codes) for the trauma that caused the PTSD. Can you post the note? In addition the counseling time spent must also be included.
 
The cause of trauma is documented in Comprehensive Assessment and the note did contain start and end time of service. Do you mean we have to send the comprehensive Assessment to the insurance co.? I would like to send you the note via your private email if I may.
Thank you.

Susan M
 
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