Health & Behavior Assessment/Intervention 96150-55

Can I use these codes for visits involving evaluation/conservative treatment of incontinence where lengthy questionnaires and pelvic floor rehabilitation (biofeedback, EMG, E Stim) are performed by a trained and experienced RN?

Health and Behavior Assessment/intervention

I suspect that these codes will deny without a behavioral diagnosis code. These codes don't seem to describe the service you are performing. These are not RN codes: they are clinician codes.

I would say no.

Health and Behavior Assessment

You should be looking at the Urodynamics codes 51725-51798. There is a code for the EMG 51784. There are 3 new codes in this section for 2010.
The office I used to work for had the RN do the urodynamic studies after the Urologist ordered them. She did them while the URologist was in the office so she could bill "incident to". Most of the time they were done on a different day subsquent to the Urologist initial visit.

96150-55

"The focus of the assessment is not on mental health but on the biopsychosocial factors important to physical health problems and treatments. The focus of the intervention is to improve the patient's health and well being utilizing cognitive, behavioral, social and/or psychophysiological procedures designed to ameliorate specific disease-related problems. Codes 96150-55 describe services offered to patients who present with primary physical illnesses, diagnoses or symptoms and may benefit from assessments and interventions that focus on the biopsychosocial factors related to the patient's health status. These services do not represent preventive medicine counseling and risk factor reduction interventions." CPT 2009

was the basis of providing the service in which education/couseling would be comprised of >50% of total time.

How are practices coding for the extended time of a RN providing EMG, biofeedback, electrical stimulation, etc? The 99211 does not seem appropriate due to the length (45 min - 1 hr) of visit and depth of visit.

96150--55

I don't think an RN is credentialed to perform those services.

96150-55

Really, not trying to argue with you, but can you read http://www.wpsic.com/medicare/part_b/policy/psych015_billing.pdf
especially the reasons for denial which include being billed by a physician, clinical nurse specialist, nurse practitioner, physician assistant, physical therapist,
occupational therapist, or clinical social worker. If not an RN, then who?

96150-55

See code 90911, this includes the EMG. Be sure to check with carriers policies. If I remember correctly Wellmark has a policy on line for biofeeback.
I'm sorry I cannot remember more about my urology coding days. It's been 2 years. But it seems like the patients had the urodynamics as part of work up then biofeedback if it was felt to be beneficial to the patient.