Mental Health Coding 90801,90802

ccosta

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I hav been assigned to oversee the coding of mental health. I do not have the expertise on these two code: 90801, 90802 ans would gladly take any help I can get. My main concern is: is there a time limit as to how many times one can use either of these codes within a given time frame. Also if a Psyschiatrist uses it one facility can another use it within that time frame, is the Dr. the only one who can use this code or can a LMHC use these codes, and lastly, if this code was used in a inpatient basis, can it be used again in the outpatient setting.
Thank you for your assistance.
Carl Costa
 

kevbshields

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The one thing I can tell you is that either an MD/DO level provider or a PhD/PsyD level provider can utilize these codes. PA/NP extendors may also utilize these codes (if they are appropriate for the service). Although I've seen LCSW use them, as an auditor, I'd question that.

Now, payers have specific limitations on the use of these codes. I believe that lends toward the confusion over use. However, we would not expect to see a patient receiving a full, diagnostic interview every 3 months (although I'm sure there are instances in which that happens).

Of note, I'd read the policies of contracted payers for details of limitations on their use/frequency.

You might be well served to create a "matrix" of frequent payers your facility bills and their particular requirements. I am not in agreement with any of the "limiting" natures placed on these codes, but I'm not paying the bills either--LOL.
Good luck.
 

dragonflye

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Hi there. Use code 90801 when it is the first evaluation by a pyschiatrist and for the therapist or social worker. 90802 is usually for kids when they have play therapy, non-vocal therapy or instances of disability with deaf/blind. The code can only be used once every year per specialty of the practice, as I said before once by the psychiatrist and then once by therapist/social worker.
 
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