Tips for Billing the New 2019 Testing Codes

The new psychological and neuropsychological testing codes present some unique challenges to completing documentation and billing in TherapyNotes. After hearing much feedback from our customers and discussion with psychologists who engage primarily in testing, we have a few tips and tricks to make handling these new codes easy while the TherapyNotes development teams continue to make improvements to the platform. There are some best practices that have been developed, but you can feel free to mix and match approaches to find what works for your specific needs.

Create $0 Service Codes

When your payer requires all dates of service to be submitted for billing on the final day but asks that documentation reflect which portion of the service was provided on each day, $0 service codes can be useful. You can schedule appointments for each component of the service prior to the final day using your new $0 service codes. This has several advantages:

You can still use TherapyNotes automated appointment reminders. Since each session is scheduled in TherapyNotes, a reminder will automatically be sent to your clients.
This allows for contemporaneous documentation. Appointments will still be eligible to be documented with a note. You can make these notes as detailed or generic as you wish (more details on documentation can be found below).
Your books are still accurate. No additional charges are made, so there is nothing to write off or no accidental client charges to refund.

Create Add-on Codes

When all charges need to be grouped on the final day of service, it may be easier to create a single note and add all the codes for billing. Especially when billing electronically, there is no difference in the appearance of a claim for an add-on code compared to a base code. This means every code can be created as an add-on code and submitted without worry or additional documentation.

Leverage Appointment and Note Types

TherapyNotes offers a variety of note templates, giving you the flexibility to match your documentation needs to the services you provide.

Continue to use the Psychotherapy Intake notes for intakes and biopsychosocial assessments. There were no changes to the coding for these services.
For testing evaluation services, use the Consultation note type. This free-form note allows you to easily document your efforts for integrating client data, clinical decision making, treatment planning, and interactive feedback to the client.
For test administration and scoring, use the Psychological Evaluation note type. This structured note readily captures the variety of tests or measures in the battery administered to your client. It also easily captures the amount of time spent scoring the measures.
If you’d like to put all of your documentation together in a single note rather than capturing the specific services on separate notes for the actual date of service, a Consultation note may be your best option.
You can use your own custom documentation and templates by leveraging the Library and Consultation services. Keep your custom forms in the Library to have them available any time you need them. Fill out your form and upload it to the client's chart.

Putting It All Together

Set up your service codes

If you schedule services over multiple days, need appointment reminders for each day, and only submit billing on the final day of service, set up $0 Consultation type service codes. Since these codes are not being submitted to insurance, they do not need to be valid codes. You can consider using codes that are meaningful to you and make picking the correct code easy.
If you need to bundle all your services on the final date of service:
- First, consider what type of note you want to use.
- Then, create a service code of that type for ONE base service (such as 96130 for testing evaluation services).
- Next, create a service code of the same type for all other codes that need to be billed regardless of whether it is intended to be an add-on code or not. Designate these codes as add-on codes. These codes should be eligible for multiple units unless they are also intended to be a base code (such as 96136 for test administration, first 30 minutes).

Schedule and document appointments

Use your $0 service codes to schedule the initial session and measure administration services. You can choose to fully document the service, or to simply note if the client attended the session. You will still be able to send appointment reminders and mark the session missed as needed.
For the final date of service, schedule an appointment with your base service.
When writing the note for your final date of service, edit the note header. Include add-on codes to represent all services and adjust the number of units to accurately reflect your billing.

Submit claims

Your initial dates of service will all be set to bill with no charge. Occasionally, they may display some errors when trying to submit claims depending on your specific settings. Simply click on the date of service and change the Status dropdown for the add-on codes to Rejected and Written Off to close out the date with no impact on your reporting.
Your final date of service will display with many add-on codes, including some that are not intended to be add-on codes. Don't panic! Even though TherapyNotes makes some formatting changes to make your claim preview easy to read (including adding the “+” symbol to differentiate add-on codes), your claim will automatically be formatted properly and should be paid out with no issues.