Wiki Inpatient Admission Psychiatric Coding

[mcgrathk0342]

The Admitting Psychiatrist is billing for the Admission CPT code 99222, he performs the admission psychiatric evaluation.
The medical staff(MD or PA) is performing the Medical review and Physical Exam.
Are both separately billable if performed on the same date of service?
Any documentation that I can find says that the Admission includes all other E/M services performed on that date of service.
We work at an inpatient state run hospital.
Please advice and thank you

 

[jessv1910]

I work in a psychiatric hospital and we bill for the Psychiatric Evaluation done by the Psychiatrist and also the H&P done by the medical doctor, both normally done on the same day. I don't do the CPT billing only the inpatient part but I always wonder if this is correct to do. I'd love to hear what other facilities are doing...

 

[napahny@aol.com]

WE are inpatient psychiatric hospital. We bill for Admission H & P 99221-99223 according to a documentation complexity for Medical Doctor.
When admitting psychiatrist seeing patient for Psychiatric diagnostic evaluation, we bill for 90792. Both encounters are on same day most of the time.
Hope this will help.

 

[ashleymblouin1@gmail.com]

I have the same question, but it says in the CPT book that you cannot bill 99222 with 90792. Does this not apply if the services are performed by two different physicians in an inpatient setting?

 

[MBERNSTEIN]

WE are inpatient psychiatric hospital. We bill for Admission H & P 99221-99223 according to a documentation complexity for Medical Doctor.
When admitting psychiatrist seeing patient for Psychiatric diagnostic evaluation, we bill for 90792. Both encounters are on same day most of the time.
Hope this will help.

I have a question with this. if 99221-99223 and 90792 are performed on the same dos with obviously 2 different providers, what modifiers would we use?

 

[jltross]

The 90791 is for a Psychiatric Diagnostic Eval
The 90792 is for a Psychiatric Diagnostic Eval with Medical Services.
At my practice, Provider A performs the Psych Eval and Provider B performs the E/M on the same day.
We bill 90791 + 9922X
90792 is for when one provider performs both the psych eval & the E/M in the same visit.. We would not bill 90792 and 9922X since 90792 already includes an E/M and it would be not be appropriate to also bill an additional E/M (9922x).
Would love to hear what others are doing.
Hope this helps.

 

[huntersmum]

I am trying to work through this EXACT situation with providers now. Two things, though:
1. For those patients who are back several times in a year, are the 9079X codes used on every admission, even for the same diagnosis? I see some restrictions around that when I read about it.
2. If I am not billing a 9079X for my psych provider, could I bill 9922X for both psych and med services, but put an AI modifier on the psych e/m?

 

[natashalage]

hello, I am still learning this specialty. To your #1. Yes, we can bill 90791-90792 every 6 months or if the same dx exacerbated and a new evaluation is needed. I read it in the file i was given and made a note of it.
#2. 90792 is a combo of psych eval and medical services: meds, ordering labs, referrals etc. I would not add 9922x

 

[huntersmum]

hello, I am still learning this specialty. To your #1. Yes, we can bill 90791-90792 every 6 months or if the same dx exacerbated and a new evaluation is needed. I read it in the file i was given and made a note of it.
#2. 90792 is a combo of psych eval and medical services: meds, ordering labs, referrals etc. I would not add 9922x

Oh, I don't mean 9079X and 9922X for the same provider. We have a med clearance exam done by medical providers. I want to bill initial for both, since the Med Service is a consult requested by the Psych docs. That is why I would bill both, but AI modifier on the psych providers code if billing 9922X for both.

 

[FractalMind]

The 90791 is for a Psychiatric Diagnostic Eval
The 90792 is for a Psychiatric Diagnostic Eval with Medical Services.
At my practice, Provider A performs the Psych Eval and Provider B performs the E/M on the same day.
We bill 90791 + 9922X
90792 is for when one provider performs both the psych eval & the E/M in the same visit.. We would not bill 90792 and 9922X since 90792 already includes an E/M and it would be not be appropriate to also bill an additional E/M (9922x).
Would love to hear what others are doing.
Hope this helps.

Hi jltross, If the psychiatrist is acting as a consulting physician (not the admitting provider), during an inpatient stay, would we use E/M codes rather than 90792 as it applies to other specialties consults (inpatient)?