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same cpt, different location, same day

Pessie Posted Mon 04th of May, 2020 15:25:44 PM
What is the correct way to code CPT 97153 for ABA treatment, when some units are performed in 2 different locations in the same day. (office and Home) in the same day. Thank You
SuperCoder Answered Tue 05th of May, 2020 12:31:10 PM



As per the coding guidelines, the MUE for CPT 97153 is 32 units, so you can bill this code up to 32 units in a single day. 


Before billing this code at two different locations in the same day, you have to check the medical necessity. If there is medical necessity to perform this adaptive behavior treatment at two different places, then you can bill this code for both the places with their respective POS code.


Please also check your payer policy whether they allow the billing of CPT 97153 at POS 12 (home) or not, and then bill accordingly. 



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