Nevertheless, practitioners are required to know everything in every line of those periodicals that might apply to their claims submissions. Storm, who provides billing guidance for psychological services in many states, recalls the case of a psychologist who government investigators found to be billing contrary to a Medicaid policy published in a newsletter before he even became a Medicaid provider. Nevertheless, she says, he had to pay back all the funds he received under that type of billing. She advises psychologists to vigorously seek guidance from their carrier, any other payer they deal with, their state associations and anyone else who can give them information on using codes. She suggests practitioners keep a three-ring binder or other collection of those pages of their carrier's newsletters that affect their practice and other pertinent information on coding and billing.
Many consultants suggest documenting any phone conversation or other information from the carrier.
Coding and documentation As part of their information search, Georgoulakis urges psychologists to educate themselves about how and when to use specific codes. Medicare carriers can vary on what they consider codes to mean and whether they will pay for them, he says, just as private insurers can. It is up to the provider, he adds, to use the code correctly for each payer, ensuring the code matches the diagnosis and documentation. Both sets of codes are updated annually. Both Storm and Georgoulakis say that psychologists don't get the education on coding that physicians do.