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90801 coding within the same practice

T

trishcrox@hotmail.com

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We have a few psychiatrists within our practice that have left and the patients have been forced to change to a new psychiatrist within our practice. We have been coding the new appointments with a 90801, but as you all know this has caused many patients to be upset because this initial code is subject to deductible and not copay for the most part. Are there any other code that would be possible and/or correct? Please advise.
 
Since you practice in a group setting wouldn't the information obtained in this 90801 evaluation already be in the patient's file? CPT Assist March 2010 has a thorough description of this code to include, "During the initial examination (code 90801), the provider conducts an interview with the patient to acquire a complete medical (including past, family, social) and psychiatric history, mental status, and a disposition to obtain a diagnosable disorder"

All of these elements should have already be in the patient's file and could be reviewed by the new therapist prior to the patient visit. Why would you not use the ongoing therapy code (either individual or group)?
 
creinhardt said:
Since you practice in a group setting wouldn't the information obtained in this 90801 evaluation already be in the patient's file? CPT Assist March 2010 has a thorough description of this code to include, "During the initial examination (code 90801), the provider conducts an interview with the patient to acquire a complete medical (including past, family, social) and psychiatric history, mental status, and a disposition to obtain a diagnosable disorder"

All of these elements should have already be in the patient's file and could be reviewed by the new therapist prior to the patient visit. Why would you not use the ongoing therapy code (either individual or group)?
Click to expand...

I agree... an established patient seeing a "new" doc in the group does not mean the patient has to start all over again.
 
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