Billing for Pelvic Health Services

[Guest guest]

Hey all,

We have some questions about billing for pelvic health services. We have run

into some issues with the 90911 code- for example, BCBS of NC will only cover

for certain diagnoses, some payors will not cover at all, including BC Federal.

So some questions:

1. If you actually do pelvic floor biofeedback, and it is not covered, can

you bill neuromuscular re-education? Some other clinics we have called are

doing that. One hospital we called just billed neuromuscular re-ed for

biofeedback and didn't bill 90911 at all.

2. What are the best treatment diagnoses to use for these patients? We tend

to use 781.3 (lack of coordination), 728.85 (spasm of muscle), and 728.87

(weakness of muscle).

3. Regarding the 4-week home program trial for Medicare before they will

pay for biofeedback: we understand how this would work for patients with muscle

weakness issues, but we often bill the 90911 code for patients with dyssyergia,

constipation, or spasm where a 4-week " trial " is useless. How are folks

handling that?

Thanks for any info.

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

(office)

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