Forum - Questions & Answers
90853
I'm looking for some assistance with billing the 90853. I am specifically having an issue with BCBS and now Humana. They are denying as "maxed units". I have always billed more than 1 unit without being denied. Of course I called BCBS and they say to look on cms they can't tell me how to bill.
I work at a outpatient MH and AODA clinic and we have group AODA therapy twice a week at 2 hours each group. I'm not seeing anything on the cms website.
Do I need to bill a different code? OR Add a modifier I'm unaware of? Thank you for any suggestions ahead of time.
90853
http://www.cms.gov/NationalCorrectCodInitEd/08_MUE.asp#TopOfPage
medicare has a daily frequency of "1" in its MUE table. Will not reimburse more than one a day.