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96127 Tricare denials

Hello we are billing Tricare South for 96127 with modifier 59 and 2 units. These are being denied stating: Billed Procedure Code(S) Pairs Found To Be Unbundled Per Cms Ncc
I can’t find any information on this. Triwest/Vets choice paid with no issues.
I did read that some payers will only pay 1 unit. Also that a 59 modifier is needed.
Anyone have any experience on this with Tricare?

Medical Billing and Coding Forum

96127 and diagnosis codes

Hi,
We use 96127 brief emotional/behavioral assessment code often and an insurance carrier is asking that when we use this for depression to use the screening for depression ICD-10 code (Z code). My question is, what if the patient already has the diagnosis of depression. I don’t feel that we would use the Z code for screening when this patient already has the diagnosis which would be an F code. Is it appropriate to use the F code with the Z code? There is no excludes notes but it doesn’t feel right to me. Hoping someone has some insight in to this.

Thanks

Medical Billing and Coding Forum

CPT 96127- which is Brief emotional/behavioral assessment (depression inventory, ADHD

Hi,

Urgent Question:

For Mental Health/Behavioral Health/Substance Abuse Services- Nebraska Medicaid- will not allow this code to be billed but said to look for similar CPT codes that would service this purpose and are billable.

Does anyone know of other CPT codes that would cover the same type of service as 96127- for MDs, Nurse Practitioners, and Licensed Therapists?

Thanks.

Medical Billing and Coding Forum

CPT 96127- which is Brief emotional/behavioral assessment (depression inventory, ADHD

Hi,

Urgent Question:

For Mental Health/Behavioral Health/Substance Abuse Services- Nebraska Medicaid- will not allow this code to be billed but said to look for similar CPT codes that would service this purpose and are billable.

Does anyone know of other CPT codes that would cover the same type of service as 96127- for MDs, Nurse Practitioners, and Licensed Therapists?

Thanks.

Medical Billing and Coding Forum

CPT 96127- which is Brief emotional/behavioral assessment (depression inventory, ADHD

Hi,

Urgent Question:

For Mental Health/Behavioral Health/Substance Abuse Services- For Medicare- Both IA & NE- is this code billable or do we have to bill similar CPT codes that would serve this purpose and are billable?

Also, how many units are billable for this service?

If 96127 is not billable- does anyone know of other CPT codes that would cover the same type of service as 96127- for MDs, Nurse Practitioners, and Licensed Therapists?

Thanks.

Medical Billing and Coding Forum

possible limits on billing 96127 emotional/behavioral assessments

My new boss says that we can only bill for these assessments once per patient. I see that we are allowed only 2 units on a claim but I can’t see anywhere where it says bill only once per patient. Anybody out there have any other info on this?

Medical Billing and Coding Forum