Working through an insurance claim is no walk in the park for a mental health practitioner, especially when your practice is small or independent. Compared to other types of medical billing, mental health billing has more complexities that make facilities prone to making mistakes during the billing process. Today, we’ll review different errors that can be made in mental health billing so you can take measures to prevent them in your practice.
Not Using the Right CPT Code
Procedure codes need to be highly specific in mental health billing. This is done so that you don’t charge too much for a shorter session or for services worth much more. Both overbilling and underbilling will put you under the scope of authorities, so you should be familiar with all CPT codes to receive the proper amount of money for each service you provide.
Bringing Up Outdated Codes
CPT and ICD codes undergo constant change, and it’s the job of a mental health practitioner to keep up to date on every change that happens with these codes. While there is a grace period while code updates are being made, payers will want you to use all the most current codes whenever you submit claims. When you use outdated codes, your claims will get denied or rejected.
In the field of mental health billing, “unbundling” refers to the act of using multiple codes to charge more money for services whenever there is an individual code that would be appropriate to use. This act should always be avoided, as it can quickly put you in hot water. Unbundling is typically considered abuse or fraud, so you should always use a single code to charge for services when possible.
Up-coding is another sneaky act that’s best avoided. While unbundling involves turning one code into multiple codes for payment, up-coding replaces a lower-paying code with a code that requires higher payment. This means you’re charging more money than you should for your services. It’s another act that could be investigated for fraud, so we want to emphasize the importance of using the correct code when calculating payment.
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