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98968

Marilyn Posted Wed 22nd of May, 2019 15:42:14 PM
i am revisiting this question. When using "98968" and the provider made the phone call from the office and the patient was at home...use pos "12" and the patient's address or is it pos 11? Thanks!
SuperCoder Answered Thu 23rd of May, 2019 11:00:04 AM

Hi,

 

You should be billing your code under POS "12" for the services rendered at Home.

 

Note:  Per CMS guidelines, services reported with CPT codes 98966-98968 or 99441-99443 are non-reimbursable codes according to the CMS Physician Fee Schedule (PFS) and are considered an integral part of other services provided.

 

Thanks!

 

Marilyn Posted Thu 23rd of May, 2019 12:20:02 PM
The provider did not go to the client's home. The provider called the client from the office. I'm thinking the session would be pos at "02" telehealth/telemedicine.
SuperCoder Answered Fri 24th of May, 2019 06:06:42 AM

Hi Marilyn,

 

I understand the concern. I too got inclined towards using POS "02" considering it as a telehealth code but problem lies in the fact that CPT code 98968 is not a Telehealth or Telemedicine code as per AMA CPT Manual. Therefore it would not be appropriate to use POS "02" in this case.

 

Hope, provided information would be helpful.

 

Thanks!

Marilyn Posted Fri 24th of May, 2019 12:50:42 PM
Since the provider did a follow up session "telehealth" non face to face, so code the session with a psychotherapy code such as 9083x with pos of "02" without the modifier "GT" to indicate that the session was not via video?
SuperCoder Answered Tue 28th of May, 2019 03:47:45 AM

Hi Marilyn,

 

You can use CPT code from the series 9083x for services performed for psychotherapy with POS "02". Codes from this series should be used specifically for Psychotherapy. There is no need to append GT modifier with the CPT code.

 

In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. Psychotherapy, also known as talk therapy, is a type of therapy in which the provider uses a series of techniques to treat the mental and emotional health problems of a patient. Psychotherapy includes the interactive process between the provider and the patient. The provider involves the patient in this therapeutic interaction with the aim to explore the thoughts, feelings, and behavior of the patient. The provider uses a variety of techniques based on relationship building, communication, and behavior change that target improvement of the mental health of the patient.

 

Hope, provided information would be helpful.

 

Thanks!

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