Part B Insider (Multispecialty) Coding Alert

Published on Fri Feb 07, 2014 PDF

Revisions to CPT’s psychiatry and psychotherapy codes last year led to helpful new coding opportunities for practices—but were also wrought with errors, CMS has determined. In an effort to quell the problems that these codes were creating, the agency issued MLN Matters article SE1407 last week, which outlines the primary problems that MACs have seen with these codes.

“The main error with the revised psychiatry and psychotherapy codes is the failure to document the time spent on the E/M service separately from the time spent on the add-on psychotherapy service,” CMS says in the article, referring to codes +90833, +90836 and +90838. “When a beneficiary requires an E/M service with a psychotherapeutic service on the same day, by the same provider, both services are payable if they are significant and separately identifiable and billed using the correct codes.”

You cannot use the time spent providing psychotherapy to meet the criteria for your E/M service or vice-versa—you must compute the time separately for the two services, CMS says.

To read the complete article on this topic, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1407.pdf.