Psychiatry Coding & Reimbursement Alert

Reader Question:

Note Bulimia Treatment Plan in Initial Interview

Question: Our psychologist saw a new patient referred by her family physician for problems with bulimia and with a family history of bipolar disorder, alcoholism, and physical abuse. The psychologist notes educational, work, and marital history and mental status as stable. He also notes treatment plan details, which include behavioral advice for lowering anxiety and reducing food cravings. What should we report?

Minnesota Subscriber

Answer: Since the psychologist specified that this was a new patient interview that included a mental status examination, you would report 90801 (Psychiatric diagnostic interview examination) for the initial interview and append ICD-9 code 307.51 (Bulimia nervosa) for the bulimia as the primary diagnosis. To capture some of the relevant family history, you may also want to report one or more secondary diagnoses, such as V61.41 (Other family circumstances; health problems within family; alcoholism in family).

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