Pediatric Coding Alert

Question: I read your article, "Capture All Your Work When Treating Kids Who Have Special Healthcare Needs" in the March issue with interest. I was wondering whether 90862 might also apply to these patients?

Answer:Absolutely. For visits involving only physician prescription management, you could consider using 90862 (Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy) instead of an office visit. The code is for addressing concerns with required medication management when the physician is directly involved in the encounter.

Keep in mind that although CPT does not restrict 90862 to mental-health providers, such as psychologists, some insurers may deny the service based on mental-health carve-outs that the plan incorporates.