Wiki Coding couples?

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shermanboise

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I've been scratching my head on this one. I've been told (by the therapists)that most insurance companies don't pay for couples counseling, and therefore that it needs to be billed as individual psychotherapy(90804).

If a maried couple go into the office and then leave after an hour of counseling, wouldn't this need to be billed as family psychotherapy(90846).

I'm new to this, I just finished school and am externing at this site. I have yet to get my certification so bare with me. Thanks.
 
Ultimately, I believe it depends on how the dictation reads.

Is one person having troubles and asking the spouse to come in so that they can work on things for that one person. Is the focus that person? If so I would bill the 90804/90806

If the focus truely is the family and how the patients issues reflect on the family and the focus is more so on the relationship functioning and how this really affects all involved vs an individual, then family might be more appropriate.

Like I said ultimately, it comes down to the focus of the visit. One code doesn't always fit a situation.
 
Also, as an FYI, if by couple counseling, you mean the family tx code, I have yet to have issues with that code being paid.. your therapists can NOT choose a certain code just because it does or doesnt get paid. That is wrong... they need to code what most accurately reflects what they did on that day
 
90847 - Family psychotherapy (conjoint psychotherapy) (with patient present) would be the code to use when therapy includes the patient and family, and would be used for couples therapy.

Individual psychotherapy (90804-90829) would be used for individual/patient only therapy.

You may want to check out the "CPT Handbook for Psychiatrists, Third Edition". I've found it to be a great resource.

Hope this helps a bit. :)
 
Although I think what I said still makes sense, I have to agree with above after re looking at CPT. It specifically says 90847 is for conjoint therapy.
 
I appreciate all your help. This has been something that's been in my mind for the last month. Thanks again for your comments!
 
couples counseling

I code for DOD (dept of defense) Our guidelines state for the initial visit code 90801/V61.10 (couple seen together)
For each subsequent visits 90847/V61.10
 
C.orna??

Which MTF do you work? I code for CRDAMC(ARMY) and I don't recall that guideline. Could you please reference the guideline page #?

Melissa
 
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