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Started by Grencik at 01-22-2010 8:34 AM. Topic has 1 replies.

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   01-22-2010, 8:34 AM
Grencik is not online. Last active: 1/22/2010 8:30:57 PM Grencik

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Joined on 01-22-2010
Illinois
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Bariatric Assessment
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?
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   04-05-2010, 11:31 AM
Barb S. is not online. Last active: 1/26/2012 1:47:24 AM Barb S.

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Joined on 12-21-2005
Posts 420
Re: Bariatric Assessment

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.


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