Wiki Mental health codes primary diagnosis in family practice setting.

[LNader]

I was recently told that in the family practice setting mental health diagnosis can never be primary because the insurance will always deny, in this case Medicare. Has anyone had this same experience? There are times when the patient is coming in for a 3 month visit to only address med refills for a mental health diagnosis. Thanks in advance for any and all help.

 

[thomas7331]

What you were told is false. While some payers may deny this, for various reasons, it's certainly not true that payers will always deny it. In any case, if that is the diagnosis that is documented as the primary reason for the visit, then that's the only one that you can use, so you really have no choice. You can't code incorrectly just because you suspect the claim might be denied.

 

[washburncherry@yahoo.com]

I was recently told that in the family practice setting mental health diagnosis can never be primary because the insurance will always deny, in this case Medicare. Has anyone had this same experience? There are times when the patient is coming in for a 3 month visit to only address med refills for a mental health diagnosis. Thanks in advance for any and all help.

I agree that is false information. Claims may end up being denied especially by Medicare due to using "unspecified mental health codes" I know that has been an issue that I have encountered due to physicians documentation.