Wiki 90862 - urgent!!!!

ddr2

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Can anyone help with the following senario???

Psychiatrist rounds on inpatient with Dementia, etc (ICD-9 331.0, 294.10, 294.8 and 294.11) for pharmacological management of his multiple medications. The code used was 90862 for each date of service.

Questions:
1. Is there any documentation that supports use of this code inpatient and
the appropriateness of utilization of this code for inpatient and outpatients?

2. Is there a "written policy" for any frequency limitation? (number of visits per month)

3. Chart documentation supports dates of service billed... which during some months was upwards of 15 visits. So the question of the appropriateness of the quantity, etc.

4. Is there another more appropriate code to utilize? ( other than an E&M since the documentation does not appear to support much in the way of E&M)

5. Anyone willing to talk to me about this who is experienced in phychiatric field? Please forward your number and I will call you

Thanks so much for an immediate response....I need this ASAP!!!
 
I sent you a message with my email.

I had a dr who wanted to bill 90862 inpatient and everyone got denied. I don't think that code is meant for hospital visits. I would look at using 99231-99233 for his rounds.

I will give you this MA link, but I am not sure that you are in the same area of the country as I and your rules may be different.

https://www.forwardhealth.wi.gov/WI...abid/151/Default.aspx?ia=1&p=1&sa=44&s=2&c=10

This policy does not allow inpatient and it only allows 4 units per month to be billed.

I would be concerned seeing 15 visits a month. I think if it is inpatient, then you should definitly look at 99231-33.

I can also give you this Medicare link, but again, not sure if it applies to your state.

http://www.wpsmedicare.com/part_b/policy/psych014.pdf
 
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