Wiki E/M codes used with Behavioral health codes

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monique11367

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Hi can anyone provide me with an example of using an E/M code with a Psychotherapy code. What situation would call for this? :confused:
 
monique11367 said:
Hi can anyone provide me with an example of using an E/M code with a Psychotherapy code. What situation would call for this? :confused:
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Monique - Many mental health codes will change as of January 1 2013. One of the big changes is that the medication management code 90862 will be termed. At that point, in most states, medication management services will be reported with E/M codes.

The excfeption is that in Louisiana and New Mexico, psycologists can provide medication management services. In those states, when a psychologist provides med management, they would code using a new code 90863.

In summary, unless you are coding for Louisianna or New Mexico, E/M codes will be used when medication management services are provided. Hope that is helpful.
 
Claudia Yoakum-Watson said:
Monique - Many mental health codes will change as of January 1 2013. One of the big changes is that the medication management code 90862 will be termed. At that point, in most states, medication management services will be reported with E/M codes.

The excfeption is that in Louisiana and New Mexico, psycologists can provide medication management services. In those states, when a psychologist provides med management, they would code using a new code 90863.

In summary, unless you are coding for Louisianna or New Mexico, E/M codes will be used when medication management services are provided. Hope that is helpful.
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Claudia,

I was wondering if you (or anyone else) would offer some insight. I am very new in dealing with Psych coding, and I am in Louisiana, so the situation you mentioned above would apply.

We have several Neuropsychologists with prescriptive privileges. If they provide Med Management but no therapy for that particular day, what should they bill? I do see the new code 90863, but that can only be used with therapy. And of course, they cannot bill E/M codes. The only other code I am seeing available for med management only is M0064, and our docs are hesitant to use it because they were told in the past that no one pays it...although it is on the current Medicare fee schedule, and I have seen it listed in crosswalks from several commercial payers.

I would appreciate any guidance anyone may have.

Thanks!!
 
monique11367 said:
Hi can anyone provide me with an example of using an E/M code with a Psychotherapy code. What situation would call for this? :confused:
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Monique,

I had this situation with an encounter just last week, the patient was seen by the Pshcyaitrist (MD) in which med management was done (a new prescription was given) and 30 minutes of Psychotherapy was done as well. I coded it this way:

99213
90832

A Psychaitrist (MD), CNS, NP's have prescriptive privledges and can perform an E/M as well as Psychotherapy. Most of the time our MD's do med management only and the Phychotherapists, PHD's, PsyD's, LCSW's and LPC's do the Psychotherapy, but cannot do med management. So this situation does not happen too often.

This may be more info that you asked for, I have spent hours reading and trying to absorb all the new codes and rules, so If I can save someone else time, I am happy to.
Melody
 
mlidmila said:
Monique,

I had this situation with an encounter just last week, the patient was seen by the Pshcyaitrist (MD) in which med management was done (a new prescription was given) and 30 minutes of Psychotherapy was done as well. I coded it this way:

99213
90832

A Psychaitrist (MD), CNS, NP's have prescriptive privledges and can perform an E/M as well as Psychotherapy. Most of the time our MD's do med management only and the Phychotherapists, PHD's, PsyD's, LCSW's and LPC's do the Psychotherapy, but cannot do med management. So this situation does not happen too often.

This may be more info that you asked for, I have spent hours reading and trying to absorb all the new codes and rules, so If I can save someone else time, I am happy to.
Melody
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You are correct, except that the code for Psychotherapy (16-37 minutes) when provided in addition to an E/M service is 90833.

90832 is a stand-alone code, used when psychotherapy is provided w/o E/M service (such as by non-prescribing providers, etc.) :)

Hope this helps!
 
ljgcpcAZ said:
You are correct, except that the code for Psychotherapy (16-37 minutes) when provided in addition to an E/M service is 90833.

90832 is a stand-alone code, used when psychotherapy is provided w/o E/M service (such as by non-prescribing providers, etc.) :)

Hope this helps!
Click to expand...

So, for a Family Practice doctor, if the pt is seen for anxiety and depression counseling, can 90833 be used with 99213? OR should 90832 be used?
Thank you!
 
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