Bariatric Assessment

Coder-To-Coder Forum

Bariatric Assessment


Grencik 01-22-2010, 8:34 AM
I am at a loss for how to bill the Bariatric Assessments 96150 for the Psych eval and then be able to bill a 90804 to get them ready for surgery.

I have been told that the 59 modifier is not useful in this situation due to CCI edits on one code. Any thoughts?

Re: Bariatric Assessment


Barb S. 04-05-2010, 11:31 AM

96150 is a health and behavior assessment. The 90804 is a psychotherapy code. Are you billing for a behavioral health provider?

My behavioral health providers bill the 96116 for the bariatric mental health assessment (assessment of thinking, judgement, etc.).

If you are not billing for a behavioral health provider, I suggest using an established patient office visit code based on time counseling, rather than 90804. 90804 requires a mental health diagnosis code in order to be reimbursed by most insurance carriers. Preparing a patient for bariatric surgery doesn't seem to be a mental problem.