Psychiatry Coding & Reimbursement Alert

Published on Wed Jan 20, 2016 PDF

Question: I am new to psychiatry coding. Our psychiatrists frequently perform medication management on the same day as scheduled psychotherapy services. When I am reporting the medication management, I have been asked to use an appropriate E/M code. I want to know in such a situation if a modifier like 25 should be appended to the E/M code that I am reporting.

Dallas Subscriber

Answer: If you look at the codes that you will report for psychotherapy, you have two sets of codes for the same time duration of psychotherapy. For instance, you can either report 90832 or +90833 when your clinician performs psychotherapy for duration of 16 to 37 minutes.

You use the add-on code such as +90833 and the other add-on codes for psychotherapy, +90836 and +90838 when your clinician performs a psychotherapy service on the same day on which an E/M service has been performed. So, when your psychiatrist performs an E/M service such as medication management, you will only have to report the appropriate E/M code for the service along the appropriate add-on code for psychotherapy.

Since there is no code bundling between the two services, you will not need to append any modifier such as 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to the E/M code that you are reporting.