What does your pdoc &/or Phd Therapist code insurance with to get you reimbused the maximum amount?

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loving frustrated wife
Veteran Member

Date Joined Jun 2007
Total Posts : 865
   Posted 5/27/2009 5:55 PM (GMT -7)   

Hi everyone, 


This may be a strange question, but we have PPO insurance, and our new therapist will only bill generic codes for our couples therapy, which we are in as a result of my H's BP and the havoc it is playing in our marriage.    She is willing to bill other codes, but she doesn't know what they are as she has never used anything else in her practice in an effort to protect her patients privacy issues - not wanting to reveal something "on record" like BP.  (She is a Phd, with several doctorates.)


I told her my goal was for maximum reimbursement, that we pay a fortune for the insurance and therefore...we need to have them pay what they should at $175 per hour.  But despite my best efforts, I cannot find the right CPT/ICD 9 or 10/DSM codes to use.  Does ANYONE out there know what they would be for a BP II, rapid cycler, in conjoint (couples) therapy? 


Thanks for your time.  She said she is happy to use whatever code I give her, but it is on me to find.   She is an excellent therapist, and is doing very well with us, but my H is ready to stop if we can't get reimbursed properly (or at least he is using that as the excuse...).  But I am heartbroken at the idea of going this alone again...so PLEASE if anyone knows....let me know.  THANK YOU!!!!!!!!!!!!!!!!  LFW

Post Edited (loving frustrated wife) : 5/27/2009 6:58:14 PM (GMT-6)

Veteran Member

Date Joined May 2007
Total Posts : 3715
   Posted 5/28/2009 8:12 AM (GMT -7)   
I'm sorry LFW,

I have no idea. It would be a real shame if this kept your husband out of therapy. I think it's unreasonable of your therapist not to find the codes, as she is the therapist, and has access to the codes.

Co-Moderator, Bipolar Forum
Bipolar II

Regular Member

Date Joined Mar 2009
Total Posts : 139
   Posted 5/28/2009 8:55 AM (GMT -7)   
I don't know what the codes are but if your H was ever hospitalized, you may find some codes on the explanation of benefits (EOB) from when previous doctors treated him. Like Serafena I find it odd that she is looking to you for the codes but perhaps looking at the EOB from when a doctor treated him for BP in the past may help.

Also, do you know anyone in medical billing? Perhaps a local medical billing training school can help you too.

I love this country but hate the way the insurance companies can sometimes prevent someone from getting the help they need. (sorry for the political vent)

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