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ABA

Marilyn Posted Wed 09th of January, 2019 15:39:10 PM
Billing for 11 units of 96152, but there is CCI edit that it's unlikely to bill more than 6units/day. How else can this be billed to capture all units?
SuperCoder Answered Thu 10th of January, 2019 03:06:32 AM

Hi Marilyn,

 

Per Medicare CCI edits, CPT code 96152 cannot be billed for more than 6 units on a single billed date of service. Even though Medicare does not allow more than 6 units, you can get in touch with your payer, if commercial, to check the maximum allowable units for this code. If your payer allows you to bill more than 6 units, ensure you have the proper documentation to support the medical necessity to bill more than 6 units on a single date of service.

 

Hope, provided information would be helpful.

 

Thanks! 

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