E/M Psychiatric Coding

pddyches

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Tollhouse, CA
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If a doctor sees a patient and needs the assistance of an LCSW during the appointment is their a way to bill the services the LCSW provided? Thank you!
 

ckeeney

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South Bend Indiana
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I think there would have to be two separate notes: one for the E/M services provided by the doctor and the note from the LCSW for their services. Since you do not specify what the LCSW did it may not be billable if not therapy or an initial evaluation. If this was an initial evaluation review the guidelines for 90792 and 90791.
 
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Another thought to consider is why exactly was the LCSW asked to join the E/M already in process? If the provider is already performing an evaluation, you can't then call in the LCSW, in the middle of the E/M and have that be considered a separate service. Even if the LCSW conducts any type of evaluation, it would be considered as bundled with the E/M. Not to mention the fact that there are a fair amount of limitations as to what an LCSW can bill for. At the same time, whatever services are provided by the LCSW shouldn't be counted when coding for the physician's E/M service. Of course the physician should document the fact that the LCSW was brought in, for what reasons, and what he/she did. The LCSW should also document separately that they visited the patient. But that would be purely for the purpose of maintaining an accurate medical record.

There's just way too much information that's unknown here, and personally, I can't think of any instance where any services of the LCSW could be billed separately in a situation like this. The only place that anything could possibly be included is if the physician's Plan includes having the patient begin therapy; the actual services of the LCSW would still not apply.
 
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