EJDD984
New
I've posted this to the Behavioral Health forum as well
I am looking for assistance understanding when a provider, psychiatrist in this case, should bill am E/M code and psychotherapy add-on and when it is more appropriate to bill just the psychotherapy code. I know the Dx can be the same for the E/M and add on, but they need to be distinct services.
If there are notes about medication administration or management, I can see how that would qualify an E/M charge but in the absence of that how can I tell if the Hist/Exam/MDM are not just being pulled from the psychotherapy session to justify and E/M charge?
We have a provider who bills in boilerplate fashion, all claims are billed with 99212 and 90836 and the same unspecified Dx, F41.9. Of note none of the medical records the provider has submitted are dated/signed, this is sufficient to deny the claims IMO but I want to also understand/address what I feel is incorrect coding.
I am looking for assistance understanding when a provider, psychiatrist in this case, should bill am E/M code and psychotherapy add-on and when it is more appropriate to bill just the psychotherapy code. I know the Dx can be the same for the E/M and add on, but they need to be distinct services.
If there are notes about medication administration or management, I can see how that would qualify an E/M charge but in the absence of that how can I tell if the Hist/Exam/MDM are not just being pulled from the psychotherapy session to justify and E/M charge?
We have a provider who bills in boilerplate fashion, all claims are billed with 99212 and 90836 and the same unspecified Dx, F41.9. Of note none of the medical records the provider has submitted are dated/signed, this is sufficient to deny the claims IMO but I want to also understand/address what I feel is incorrect coding.