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X code for neuropsych testing

Judi Posted Fri 09th of December, 2011 20:20:20 PM

The code we usually bill is 96118 for any kind of insurances. However, the CCS (California Children's Medical Services)program only accepts the code- X9514 (Test Administration, includes pre-interview one complete hour). We tried to bill X code based on total hours completed as indicated in Medi-Cal website (eg. X9524 for six hour complete hours), but the X9524 won't be authorized by CCS. Therefore, we billed X9514 with total hours on unit. Unfortunately, they only paid 1 unit on X9514. I'm looking for any advices about X code for neuropsych testing. Thanks

SuperCoder Answered Fri 09th of December, 2011 22:42:35 PM

I am new to this forum. Can you please tell me what is the source of X9514 ? This will be good thing for me to learn.

Judi Posted Fri 16th of December, 2011 16:54:04 PM

http://files.medi-cal.ca.gov/pubsdoco/manuals_menu.asp?pg=&PgDwn=Yes&hURL=&qu=x9514#top_search
You can visit Medi-cal website, and select the CCS program. Any suggestions what to bill for X code?

SuperCoder Answered Tue 10th of January, 2012 20:10:28 PM

I found some Medi-Cal info online that lists X9514 as what you report for the test and pre-interview up to a maximum of 6 hours. My understanding from that info is that you'll only report 1 unit of X9514 for your test. If that policy's still in place, that would be why they didn't reimburse you for multiple units on your second claim -- you only get 1 unit of X9514 because it represents the 6 hours you're reporting.

Judi Posted Fri 20th of January, 2012 20:17:58 PM

As mentioned above, we tried to bill X9524 to match with 6 hrs, but the claim was denied due to invalid code. Per CCS website, the X9524 is not authorized in service code-02, only X9514 (one hour) and X9516 (2 hours). Also, my co-worker called to talk with case manager and they said to use X9514! Really a conflicting everything! That's reason I need help how to bill X code for neuropsych testing...

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