Wiki 99232 VS 90817 when counseling is done?

[Orthocoderpgu]

I code for I/P Psych patients.
After speaking with one of my docs, I found out that sometimes they spend most of their time during their daily visits counseling the patient. So if my doc goes on their daily rounds, and they spend most of the time counseling the patient, which code set do I use? Most of the time we use code set 99232. Basic physical exam is always done. But how can I tell when to use 90816 or 90817 vs 99232? Thanks for any input!

 

[smdumpert]

It's my understanding to use the 90817, 90819, and 90822 they have to specifically state the type of therapeutic intervention or counseling used, like supportive therapy, behavioral modification, insight oriented. Then the amount of time used would determine which of the 3 codes listed above you would choose.

 

[kevbshields]

Exactly. The intent and purpose of the service should drive code selection. Some psychiatrists and facilities have the MDs manage "medical" and "pharmacological" issues, while psychologists, LCSWs, etc manage the therapy. In those instances, the MDs would normally code for the 99231-99233 service.

As you describe it, psychotherapy is a substantial portion of the patient encounter and that would push the use of the 908XX series.

Sometimes this is confusing for coders.