Frequently Asked Questions

Procedure Codes

• When would we use procedure code 910, 911, 912, 913, 914, 915? Procedure code 910, 911, 912, 913, 914, 915 is to be used for an Initial IEP Development. This code is specifically for a child who is new to special education and this is the first time that an IEP is being written for this child.
• How many times can we submit an encounter for procedure code 910, 911, 912, 913, 914, 915? Procedure code 910, 911, 912, 913, 914, 915 is the Initial IEP Development encounter. This encounter may only be submitted once during the life of the child.
• When is an outcome statement required? You should use an outcome statement anytime you use Code 920, 921, 922, 923, 924, 925 on the encounter form.
• What is the difference between procedure codes 910, 911, 912, 913, 914, 915 and 930, 931, 932, 933, 934, 935?
  • Procedure Code 910, 911, 912, 913, 914, 915 is the Initial IEP Development. This procedure should be used for a child who is NEW to special education and this is the first time the child has ever had an IEP.
  • Procedure Code 930, 931, 932, 933, 934, 935 is the Periodic IEP Team Meeting/Review. This procedure is designated for IEP Team meeting, special, annual or triennial review of the IEP.
    
    Remember to staple the IEP Team Summary notes for Procedure Code 910, 911, 912, 913, 914, 915 and 930, 931, 932, 933, 934, 935 to the encounter form at the time you send the encounter form in.
    
    
• When should we staple IEP Team Notes to the Encounter Data Form? You should staple a copy of the IEP Team notes to encounter data form whenever using procedure codes 910, 911, 912, 913, 914, 915 or 930, 931, 932, 933, 934, 935.
• We may hold an intake conference team meeting for a child; can we submit encounter data for this service? You may submit an encounter data for this service using Code 930, 931, 932, 933, 934, 935 the Periodic IEP Team Meeting/Review. Be sure to staple the notes from the intake to the encounter form when submitting it to the Office of Third Party Billing.
• Do IEP Team meetings supercede monthly IEP case management? If so, how do we denote additional contacts for students who receive special transportation? If a child has an IEP Team (Procedure Code 930, 931, 932, 933, 934, 935) and a Monthly Ongoing Case Management (Procedure Code 920, 921, 922, 923, 924, 925), in the same month, the IEP Team meeting (Procedure Code 930, 931, 932, 933, 934, 935) will always supercede the Monthly Ongoing IEP Case Management encounter. In order to complete the case management area of the encounter data form correctly, please place the letter of the outcome statement that applies in the box of any additional dates that the student received a case management service.
• We have had occasions when the team notes from the IEP Team meeting are not ready when we need to send our encounter data forms. Can we send the encounter form in, and forward the team notes at a later date? No, do not send your encounter form to the Office of Third Party Billing without the IEP Team meeting notes. Please hold your encounter data form until the notes from the team are ready to be stapled to the encounter form. The Office of Third Party Billing receives thousands of encounter forms each month and it is impossible to hold encounter forms for any kind of correction(s) or notes. Your form will be returned to your IEP Chairperson if it does not have the appropriate documents attached.