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90792 without mental health DX

M

meland66

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Fresh Meadows, NY
Hello,

Often our providers are asked to evaluate a patient exhibiting behavioral health signs or symptoms or for medical decision making capacity. What can they report if at the end of the encounter a MH DX was not established. The LCD for 90792 contains mostly F-codes.

Thanks, Melanie.
 
Sorry for the delayed response. Psychiatrists are performing the diagnostic evaluations, usually for ED patients, I have been using Z04.6 or Z04.8

We also have Psychiatrists evaluating the decision making capacity of medical patients. If the patient is found to be cognitively intact I have used Z04.8

I was wondering for either situation if there was a more appropriate code, thanks Melanie.
 
Hi,
Here is the LCD for Psychiatric codes https://www.cms.gov/medicare-covera...tHcpcsCode=90791&kq=true&bc=IAAAACAAAAAAAA==&
Look at the bottom of the dx list and select the different pages. There are more then just the F codes. Starting on page 6 there are more choices.
The general rule we've used is to code symptom/sign codes if no dx was determined at the end of the eval. There are some R codes in the area of R45.xx that you should be able to find a fitting one. Anger R45.4; R45.89 Symptoms related to emotional status; R41.840 attention type symptoms.

Hope the link opens the LCDs for you.

Barbara
 
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