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IMA Admin Update
March 28, 2013
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Spring Update
Below is some important information for you, our customers. Please review and contact us if you have any questions.
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2013 Psychotherapy CPT codes - More changes
OMH has just announced some more changes in how to use the new CPT 2013 codes. Here is a review of the latest rules with the IMA recommendations on how to implement.
Psychotropic Medication Treatment
CPT code: In the initial guidance from OMH, these services could be billed with either 90863 or an E&M code. This guidance has been changed and an E&M code must be used. IMA suggests changing the activity codes for these services to the E&M code.
"HE" Modifier: OMH clinics are also advised to add an "HE" modifier to these services. in order to do so, the HE should be added to the SRVMDF table and could be added in the activity code definition as a "CPT Modifier" (on the billing tab).
Psychiatric Assessment
OMH is requesting that the "HE" modifier be added to both the E&M code and the Psychiatric Assessment "add-on" that are used for Psychiatric Assessments. This should also be added in the activity code definitions.
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OMH Health Services and Off-site billing
OMH reports that they have loaded the rates for health services and off-site billing retroactive to July 2010. They recommend that these services can now be billed with a delay reason of "3". You should be able to do this on your own within our application but if you require assistance please let us know.
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Medicare E&M codes
A number of customers have reported a high number of denials for Medicare services starting in 2013. A number of issues have been identified.
1. Modifier "59" versus "25": The "59" was used in the past for multiple services the same day. It seems that E&M codes need a "25" instead
2. Combining multiple services in the same "claim": Much like APG billing, there are cases where Medicare wantS to see certain services combined in the same claim (i.e. the E&M code and the Psych Assessment add-on).
IMA is now reviewing and testing methods to accommodate this. We will communicate soon on how we recommend this be done.
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Add-on Services Module
IMA has released a new module for managing the "addon services" that are needed for after hours and for Psychiatric Assessments. This new module gives more visibility to the services requiring the addons and more flexibility in controlling the services and payers that requires these addons to be created. Please contact the helpdesk for more details or to schedule implementation.
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IMA Phones
We have installed a new phone system at IMA. The opening message has changed a bit but the extensions have been kept the same. Please note that some employees had a "private" extension beginning with the digit "2". These extensions no longer work.
If you experience any problems getting through please let us know.
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