Wiki Compliance/auditing a psych clinic

[1073358]

Does anyone ever go in and audit a psychiatry clinic? I am looking for advice and ideas on how I can make our program stronger. Exactly what do you look at and how?

 

[kson68]

What I looked for depended on what CPT codes the provider(s) were using and if they were inpatient or outpatient. Do your providers use Psych specific CPT codes or do they use E&M codes as well?

 

[SHIBA425]

Audit of Psych Clinic Services

We developed audit tools from the CPT codes and listed each element required to support the specific code billed. For example, psychotherapy requires the documentation include what psychotherapy techniques/interventions were used and describe how they benefited the patient in reaching his/her goals (Supportive, Behavior modyfying, cognitive etc..)

I reccomend reviewing the codes and lay descriptions, and it does not hurt to review your carrier guidelines as well.

Hope this helps.
Jeanne