Wiki AMA accepted coding changes for Psych

[smdumpert]

I just saw the code changes that the AMA accepted for psychiatry, has anyone else heard anything about them?

 

[kevbshields]

No. How drastic are they and do they align more with what behavioral health providers supply as service to patients?

 

[smdumpert]

At this point the American Medical Association (AMA) has released only general information about the code changes. We understand that additional details about the new coding schema will be available on or about August 31, 2012 and we will make this additional information available to you as soon as it is released.

The summary below is from a chart published by the AMA. Most significantly code 90862 (Pharmacologic Management) has been eliminated. We believe that the expectation is for psychiatrists to use general evaluation and management codes (99xxx series). These codes are used by most physicians, but have not generally been used in behavioral health settings.

AMA accepted the following coding changes:

establishment of code for pharmacologic management with concurrent deletion of code 90862;
revision of Psychiatry guidelines;
addition of code 908XE for interactive complexity;
deletion of codes 90804-90809, 90810-90815, 90816-90822, 90823-90829, 90857;
addition of codes 908P10, 908P10X, 908P20, 908P20X, 908P30, 908P30X, 908CP2, 908CP2 for psychotherapy; and
revision of codes 90875, 90876

 

[Brenda Ray]

Code Changes

So, have you heard or seen anything about the code changes for Psych?

 

[KMorris23]

I have seen the revisions to the code set, but I am looking to see if anyone has seen what CMS has said. I am pretty sure at this point they have accepted the changes, but I have not found them as yet. If anyone has a link please let me know. I am trying to clue in on what the guideline changes look like.

 

[wahmcoder]

Diagnostic interview examination
90801-DELETED
Code 90791 - Psychiatric Diagnostic Evaluation without medical services.
The evaluation may include communication with family or other sources, and review and ordering of diagnostic studies. Use +90785 in conjunction with 90791 when the diagnostic evaluation includes Interactive Complexity services.

Code 90792 - Psychiatric Diagnostic Evaluation with medical services.
The evaluation may include communication with family or other sources, prescription of medications, and review and ordering of laboratory or other diagnostic studies. Use +90785 in conjunction with 90792 when the diagnostic evaluation includes Interactive Complexity services

Codes 90791, 90792 may be reported more than once for the patient when separate diagnostic evaluations are conducted with the patient and other informants on different days.


Interactive diagnostic interview examination
90802-DELETED

Individual psychotherapy
90804, 90806, 90808, 90816, 90818, 90821-DELETED

Interactive individual psychotherapy
90810, 90812, 90814, 90823, 90826, 90828-DELETED

Individual psychotherapy with E/M
90805, 90807, 90809, 90817, 90819, 90822-DELETED

Interactive individual psychotherapy with E/M
90811, 90813, 90815, 90824, 90827, 90829-DELETED
Code“Exact” Time (in minutes) Actual Time Range (in minutes)
90832, +90833 30 16-37
90834, +90836 45 38-52
90837, +90838 60 At least 53
Family psychotherapy
90846, 90847, 90849-Retained

Group psychotherapy
90853-Retained

Interactive group psychotherapy
90857-DELETED

Pharmacologic management
90862-DELETED
Code +90785 is an add-on code to report Interactive Complexity services when provided in conjunction with the psychotherapy codes 90832-+90838
Psychotherapy for Crisis – Codes 90839 and +90840
Pharmacologic Management add-on code – +90863
Medical Team Conferences Without Direct Contact with the Patient and/or Family
99367

 

[efrohna]

WAHMCODER,
Do you have a link with all this information? I have not seen anything. If you could paste the link to your response that would be great!
Thank you!!

 

[mitchellde]

It is in the 2013 CPT book , I received my book last week.

 

[laura_clffrd@yahoo.com]

so thoughts on 90837 if the pt was seen for 75 minutes? would there be a 10 minute and 20 minute?

 

[wahmcoder]

There is an errata effective Jan 1. If you spend at least 90 minutes or longer you will use the prolonged services codes 99354-99357

 

[laura_clffrd@yahoo.com]

99354 says to code first an e/m ... Which wouldn't be the 90837...so i am confused

 

[1073358]

61+ therapy

From what i read, bill 90837+99354. But the notes under 99354 in CPT do not reflect this, but notes under 90837 in CPT do.

Here is NGS's take on it:

http://www.ngsmedicare.com/wps/port...CONTRACTTYPE=Title XVIII Providers&LOB=Part A

 

[heatherwinters]

Psychotherapy Time in New York State

There does not seem to be a clear consensus in terms of the time element of the new psychotherapy codes in New York State.

The NGS LCD L26895 indicates they will accept rounding of time to the nearest code but does not accurately reflecting the ama errata of 90 rather than 68 minutes to use prolonged service code with 90837.

Procedure codes 90832-90838 (psychotherapy for 30 to 60 minutes) – report the code closest to the actual time (i.e., 16-37 minutes for 90832 and 90833, 38-52 minutes for 90834 and 90836, and 53 or more minutes for 90837 and 90838.

OMH for New York seems to be stating they will NOT allow rounding and require a minimum of 30 minutes to be Medicaid Billable. http://www.omh.ny.gov/omhweb/clinic_restructuring/CPT_crosswalk_20121130.pdf

Has anyone seen anything official from New York State Medicaid concerning the changes? As of yet no official New York State Medicaid update has been published for January.

 

[ACollison]

Has anyone else seen any language on the 90791 and 90792. I have come across one post that indicates all non medical providers such as nurse practioner can only use 90791 and that psychiatrists can use code 90792. Any feed back would be appreciated

 

[barry_henson]

links

this link might help people. it's just a simple crosswalk

http://www.oregon.gov/oha/amh/mho/codes/apa-changes-2012-2410.pdf