Wiki 90792 How many times can this code be used for same patient?

[jsquinto]

I work for a Behavioral healthcare practice, and the providers have asked if code 90792 is only for New Patients or is it a code that can be used for the same patient at the patients? next visit? Patient is seen every 2-4 weeks.

I thought that this was for a new patient/Initial visit and could only be billed once a year.

Can someone clarify this for me?

 

[MorrowL4]

Per CPT - Codes 90791, 90792 may be reported more than once for the patient when separate diagnostic evaluations are conducted with the patient and other informants. Codes 90791, 90792 may be reported once per day and not on the same day as an evaluation and management service performed by the same individual for the same patient.

In my facility we were told no more that 3 times per year and can only be used more than once when either circumstances change, new provider, or long lapse in service.

 

[jsquinto]

MorrowL4, thank you for your explanation. I like your facility rules, will have to let my providers know.

 

[phyllisbettino01]

Billing 90791 even if the patient is not new?

Can I bill 90791 again for a patient when a new problem arises even though the pt is not new to the provider?

 

[MJ4ever]

3 times total per year per MCR guidelines. This is for initial psychiatric exams 90791 and 90792.

 

[julie@medexplus.com]

I am trying to get the 90792 through for an IOP facility for a client with SA DX and getting error message. I have used rev code 900, which I would normally get paid on for 90791. The BCBS rep said per the guidelines use 906, rejected on both ??? Bill type 131
Any advice would be greatly appreciated.

 

[BenCrocker]

In Vermont BCBS says for a Psychiatric Diagnostic Evaluation psychiatrists can use an E&M code in lieu of 90792.

http://vtmedicaid.com/Downloads/man...nual/Summary of Updates New Manual 4-1-14.pdf Page 46-7