Mental Health Question M0064

lschoen

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We have a difference of opinion in our clinic. Are there any Mental Health experts who can help? We have two providers, one psychologist and one psychiatrist both work under the same tax id-same clinic. Our patient is seen by the psychologist first (say 30 minutes) than immediately following goes to the psychiatrist for medication management. Should the providers report the service separately-90804 under the psychologist and M0064 under the psychiatrist. OR code 90807 (to include the psychiatrist 10-15 min.) under the psychiatrist. Thank you.:confused:
 

efrohna

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Appleton
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If have never billed M0064 - what cirumstances are you reporting this? In my opinion, I would bill separately. Especially, because 90804 is time based. Since a psychologist cannot report 90862, the psychiatrist should (if documentation supports it). There should be two separate reports, to report two separate visits & codes.

Since we are talking about Psych codes. According to the LCD for the state of Wisconsin, there should be a mental status exam documented in the patient's note in order to report 90801 & 90862. What bullets in the '97 single system psych exam component are you looking for during a chart review?
 

janetmoh

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We bill the psychiatrist and psychology separately. They are two different services
 

lschoen

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I realize there are two specialist. However, I was thinking since we have one member being treated in the same clinic that we would only use one codes. The only reason the psychiatrist is involved is to manage the members meds after the phychologist does the pschotherapy:confused:
It would be the same if a member was being treated by a PA and a doc same date, same fed id #.
 

grahamki

Networker
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Morgantown
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At our facility we bill each as long as the documentation is in the patients chart. Since the Physician is managing the medication 90862 and the pyschologist is managing the therapy 90806 of the patient.

Hopes this helps.

Kimberely Moore, CPC
 
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