H0004 has been hit or miss with Anthem. 70% of the time, it's denied with the reason that it requires pre-authorization. I've spoken with Anthem about this to tell them that pre-authorization for an extended/prolonged session cannot usually be predicted; however, no luck. I didn't know about G2212 - thank you so much for sharing that. I'll give that a shot.
Is EHR required for ALL the codes (new or OLD) in order to bill a prolonged service? Looking to keep things as simple and reliable as possible for the tech challenged. What's the simplest way as of this date to bill for 90 or more minute sessions?
Unfortunately, there is no easy way to do it. As many of the new codes and options are just approved by specific providers and the only way to find out is to call. Ideally, two 90834's would be great but you have to check if it's allowed.
Thank you thank you thank you thank you for answering this so succinctly. I'll give it a shot with my superbillers and see how it goes.
H0004 has been hit or miss with Anthem. 70% of the time, it's denied with the reason that it requires pre-authorization. I've spoken with Anthem about this to tell them that pre-authorization for an extended/prolonged session cannot usually be predicted; however, no luck. I didn't know about G2212 - thank you so much for sharing that. I'll give that a shot.
Thanks for sharing your experience! I’d love to hear how G2212 goes for you
Is EHR required for ALL the codes (new or OLD) in order to bill a prolonged service? Looking to keep things as simple and reliable as possible for the tech challenged. What's the simplest way as of this date to bill for 90 or more minute sessions?
Unfortunately, there is no easy way to do it. As many of the new codes and options are just approved by specific providers and the only way to find out is to call. Ideally, two 90834's would be great but you have to check if it's allowed.