Can Dr. change dx code for psy consult?

All of my consults have been paid for except for the psy consult.  I talked wit Empire and they said it is because since it was billed as a mental health consult that the Dr. needs to put a mental health dx code instead of just obesity.  I called his office and was told that the code could not be changed. I used to do medical ins in several practices many years ago and a Dr. could put whatever he/she wanted as the dx.  Is this still not the case?  This guy charged $660 for this consult (talk about a rip off!) and I will be dxxx if I am going to pay the full thing.

I am a licensed clinical psychologist in NYS and I certainly agree if I read you post correctly. First of all you have to distinguish between the CPT code used (which defines the service rendered) and the Dx (which describes the perceived disorder). A psychologist is not a medical doctor and should certainly NOT be Dx'ing anyone with "obesity" as that's a purely medical Dx. You may want to check and see if the claim was rejected because of the CPT code used. If it was coded as "psychological testing" (http://www.apa.org/monitor/feb05/codes.html) many insurance companies will require that this be precertified either prior to the date the service was rendered or withing 48 hours. Otherwise it will be denied. As for the Dx, the psychologist in question could certainly have used a code like 309.28 or another "Adjustment Disorder" to describe the problem. While this is, of course, an individual professional decision, I have always made an effort to assist my patients.  I'm sorry to hear that your experience was not a positive one. Even if you're not successful in getting reimbursed for this, believe me, the benefits of WLS will surely outweigh (pun intended) any expense you may have had to lay out. Good luck in your journey.