Wiki Behavioral Health and Psych Resources

[buskeys]

Hi!

Does anyone have any good Behavioral Health and/or Psychiatry resources for coders? Whether that be books, manuals, articles, papers etc.

Thanks

 

[CJTrujillo]

If you have access to an Optum Healthcare Advocate they have great resources on many of these topics. It's in a portal so they grant you access.
I found a DSM-5 at the local library and read that for great information as well.
AAPC probably has a webinar on the topic as well.
And Google, look for reputable resources like American Psychiatric Assoc. Also, here is a link to a sheet from the University of Washington https://aims.uw.edu/sites/default/files/Basic Coding for Integrated BH 2020.pdf
Best wishes,
Cari

 

[SharonCollachi]

I worked in Behavioral Health (for psychiatry, psychology, LCSW, MFT) for about 15 years before switching over to Pain Management 7 years ago. Back then a lot of stuff was trial and error; alot more is available now. I started with my Medicare's billing guide for mental health. If an insurance company had a policy about it, I got a hold of it. If something was denied, and the insurance company had no written policy, then I used my other resources to fight it.

 

[lonbonone]

I work in family practice and we hired LMHC (licensed mental health counselor). I contacted Medicare Part B and was advised that LMHC provider cannot be credentialed with Medicare Part B but they can bill 'as incident to' on the claim. I was told by Medicare rep the medical provider is rendering provider and LMHC provider is servicing provider. I was wondering if this is correct and if so, does the patient need to be established in the practice to receive the behavioral health service or can they be a new patient? If new patient - what role would the provider be responsible for (i.e. see the patient briefly or make a note on the chart that the chart was reviewed).
We have a new Medicare patient scheduled tomorrow and any assistance/comments would be greatly appreciated!

 

[csperoni]

I am not familiar with behavioral health billing, but if you are following "incident to" billing rules, it may NOT be a new patient.
https://www.aapc.com/blog/44912-seven-incident-to-billing-requirements/

 

[SharonCollachi]

I work in family practice and we hired LMHC (licensed mental health counselor). I contacted Medicare Part B and was advised that LMHC provider cannot be credentialed with Medicare Part B but they can bill 'as incident to' on the claim. I was told by Medicare rep the medical provider is rendering provider and LMHC provider is servicing provider. I was wondering if this is correct and if so, does the patient need to be established in the practice to receive the behavioral health service or can they be a new patient? If new patient - what role would the provider be responsible for (i.e. see the patient briefly or make a note on the chart that the chart was reviewed).
We have a new Medicare patient scheduled tomorrow and any assistance/comments would be greatly appreciated!

As stated, incident-to services cannot be provided to a new patient. For an established patient, the billing provider must establish a plan of care. The non-billing provider then follows that plan of care on subsequent visits. A physician (not necessarily the billing physician) must be in the office suite when the incident-to services take place.

An often-overlooked component of incident-to billing is that it cannot be used when the time factor (not the complexity) is used to choose the service - meaning more than 50% of the visit is spent on counseling or coordination of care.
Out of curiousity, what type of provider is the medical provider?