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ED Coding and Reimbursement Alert

Reader Question:

90801 vs. E/M

Published on Thu Mar 01, 2001

Question: A psychiatric patient usually comes to the ED either under court order or with the police carrying an emergency petition that requires psychiatric evaluation. How should this be coded? Is 90801 an option?

Maryland Subscriber

Answer: Whether you code the evaluation of psychiatric patients on an evaluation and management (E/M) level or use 90801 (psychiatric diagnostic interview examination) depends on the supporting documentation. If the documentation supports a psychiatric diagnostic or evaluative interview procedure that includes a history, mental status, and a disposition, and possibly communication with family or other sources, ordering and medical interpretation of laboratory or other medical diagnostic studies, it would qualify for 90801.

Also, according to Medicare, you can use 90801 in the ED because there are no place of service restrictions. But, youll need detailed documentation for reimbursement.
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