Psychiatry Coding & Reimbursement Alert

Reader Question:

Don't Expect Reimbursements for Reduced E/M Services

Question: Our psychiatrist recently saw a patient in our hospital for a consultation. After our psychiatrist spoke with the patient and reviewed his chart, the patient turned uncooperative and refused further examination. Although he spent time with the patient, it does not warrant even level one coding. Can we bill any E/M services in this situation?

California Subscriber

Answer: Unfortunately, it doesn't sound like your psychiatrist did enough to warrant any reimbursement for the time he spent. However, you can try to report his services using the unlisted E/M service code: 99499 (Unlisted evaluation and management service).

It is best to send whatever documentation there is from the visit to the payer when reporting 99499. Then, the payer will decide if there was enough to pay any fee. However, it is better that you are not over-expectant as you may not receive any payments for the services and time spent by your psychiatrist with the patient.

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