RE: ABA reimbursed by insurance?

[Guest guest]

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

From: marthawood@...

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha

[Guest guest]

We used Procedure Code 99199 and Diagnosis Code 299.00

From: [mailto: ] On Behalf Of

Sent: Tuesday, May 12, 2009 12:55 PM

nids

Subject: RE: ABA reimbursed by insurance?

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha

[Guest guest]

I have had success getting it covered by UnitedHealth Care Humana and BCBSTX

....Procedure code we have used 99215 90808 ..diagnosis code I will have to look

it up ...my memory not so good ....Candi

From: marthawood@...

Date: Tue, 12 May 2009 13:17:20 -0500

Subject: RE: ABA reimbursed by insurance?

We used Procedure Code 99199 and Diagnosis Code 299.00

From: [mailto: ] On Behalf Of

Sent: Tuesday, May 12, 2009 12:55 PM

nids

Subject: RE: ABA reimbursed by insurance?

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha

[Guest guest]

Thank you so much. We will try these codes.

Martha

From: [mailto: ] On Behalf Of Candi

DAVIS

Sent: Tuesday, May 12, 2009 2:18 PM

Subject: RE: ABA reimbursed by insurance?

I have had success getting it covered by UnitedHealth Care Humana and BCBSTX

....Procedure code we have used 99215 90808 ..diagnosis code I will have to

look it up ...my memory not so good ....Candi

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 13:17:20 -0500

Subject: RE: ABA reimbursed by insurance?

We used Procedure Code 99199 and Diagnosis Code 299.00

From: <mailto:%40>

[mailto: <mailto:%40> ] On Behalf Of

Sent: Tuesday, May 12, 2009 12:55 PM

nids <mailto:nids%40>

Subject: RE: ABA reimbursed by insurance?

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

<mailto:%40>

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha

[Guest guest]

We use the CPT codes 90806 and 90808. We use the diagnosis code is 348.30

and 985.90.

Our health insurance is with United Health Care. Below is their medical

policies page. Once you click on the link below search for "

<javascript:openTheLink('cmaIndexResult.do?channelId=016228193392b010VgnVCM1

00000c520720a____ & htmlFilePath=/ccmcontent/ProviderII/UHC/en-US/Assets/Provi

derStaticFiles/ProviderStaticFilesHtml/MedicalPolicies/Intensive_Behavioral_

Therapy_for_the_Treatment_of_Autism_Spectrum_Disorders.htm',true,'')>

Intensive Behavioral Therapy for the Treatment of Autism Spectrum

Disorders " . Notice that in the ABA medical policy they mention a few CPT

codes, all these CPT codes are in the range of 908xx.

https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=0162281933

92b010VgnVCM100000c520720a____

In our case, last year we had a POS health plan and there was a limit of 60

days of ABA therapy per calendar year. This year we chose PPO which it

doesn't have a limit in the amount of days of therapy per year. The PPO

plan does have higher out of pocket deductible. We get reimbursed 50% of

ABA because the ABA provider is not in network.

Hope this helps,

JR

From: [mailto: ] On Behalf Of Martha

Wood

Sent: Tuesday, May 12, 2009 6:07 PM

Subject: RE: ABA reimbursed by insurance?

Thank you so much. We will try these codes.

Martha

From: <mailto:%40>

[mailto: <mailto:%40> ] On Behalf Of

Candi

DAVIS

Sent: Tuesday, May 12, 2009 2:18 PM

Subject: RE: ABA reimbursed by insurance?

I have had success getting it covered by UnitedHealth Care Humana and BCBSTX

....Procedure code we have used 99215 90808 ..diagnosis code I will have to

look it up ...my memory not so good ....Candi

<mailto:%40>

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 13:17:20 -0500

Subject: RE: ABA reimbursed by insurance?

We used Procedure Code 99199 and Diagnosis Code 299.00

From: <mailto:%40>

<mailto:%40>

[mailto: <mailto:%40>

<mailto:%40> ] On Behalf Of

Sent: Tuesday, May 12, 2009 12:55 PM

nids <mailto:nids%40>

<mailto:nids%40>

Subject: RE: ABA reimbursed by insurance?

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

<mailto:%40>

<mailto:%40>

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha

[Guest guest]

Thank you so much. This is very helpful. Hopefully it will work.

Martha

From: [mailto: ] On Behalf Of

Sent: Tuesday, May 12, 2009 6:56 PM

Subject: RE: ABA reimbursed by insurance?

We use the CPT codes 90806 and 90808. We use the diagnosis code is 348.30

and 985.90.

Our health insurance is with United Health Care. Below is their medical

policies page. Once you click on the link below search for "

<javascript:openTheLink('cmaIndexResult.do?channelId=016228193392b010VgnVCM1

00000c520720a____ & htmlFilePath=/ccmcontent/ProviderII/UHC/en-US/Assets/Provi

derStaticFiles/ProviderStaticFilesHtml/MedicalPolicies/Intensive_Behavioral_

Therapy_for_the_Treatment_of_Autism_Spectrum_Disorders.htm',true,'')>

Intensive Behavioral Therapy for the Treatment of Autism Spectrum

Disorders " . Notice that in the ABA medical policy they mention a few CPT

codes, all these CPT codes are in the range of 908xx.

https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=0162281933

92b010VgnVCM100000c520720a____

In our case, last year we had a POS health plan and there was a limit of 60

days of ABA therapy per calendar year. This year we chose PPO which it

doesn't have a limit in the amount of days of therapy per year. The PPO

plan does have higher out of pocket deductible. We get reimbursed 50% of

ABA because the ABA provider is not in network.

Hope this helps,

JR

From: <mailto:%40>

[mailto: <mailto:%40> ] On Behalf Of

Martha

Wood

Sent: Tuesday, May 12, 2009 6:07 PM

<mailto:%40>

Subject: RE: ABA reimbursed by insurance?

Thank you so much. We will try these codes.

Martha

From: <mailto:%40>

<mailto:%40>

[mailto: <mailto:%40>

<mailto:%40> ] On Behalf Of

Candi

DAVIS

Sent: Tuesday, May 12, 2009 2:18 PM

Subject: RE: ABA reimbursed by insurance?

I have had success getting it covered by UnitedHealth Care Humana and BCBSTX

....Procedure code we have used 99215 90808 ..diagnosis code I will have to

look it up ...my memory not so good ....Candi

<mailto:%40>

<mailto:%40>

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 13:17:20 -0500

Subject: RE: ABA reimbursed by insurance?

We used Procedure Code 99199 and Diagnosis Code 299.00

From: <mailto:%40>

<mailto:%40>

<mailto:%40>

[mailto: <mailto:%40>

<mailto:%40>

<mailto:%40> ] On Behalf Of

Sent: Tuesday, May 12, 2009 12:55 PM

nids <mailto:nids%40>

<mailto:nids%40>

<mailto:nids%40>

Subject: RE: ABA reimbursed by insurance?

Martha,

What procedure and diagnosis codes did you use?

Thanks,

JR

<mailto:%40>

<mailto:%40>

<mailto:%40>

<mailto:%40>

From: marthawood@... <mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

<mailto:marthawood%40comcast.net>

Date: Tue, 12 May 2009 11:37:20 -0500

Subject: ABA reimbursed by insurance?

Hello all,

We have recently been denied coverage for ABA by our insurance because we

used an " investigational procedure code " . We currently have BCBS of TN. I

wondered if anyone has had success getting their insurance to cover ABA and

if so what procedure code was used.

Thanks for your help.

Martha