Wiki Mental Status Exam in lieu of Review of Systems?

Hi,
In determining the level of E&M for psychiatry, can the Mental Health Exam items be counted instead of the Review of Systems?

An exam is not a review of systems - these are two different things and not interchangeable. The review of systems consists of questions that a provider asks about what symptoms a patient has been experiencing. A mental status exam would consist of the provider's documented observations of the patient. The ROS is subjective, based on patient responses; the exam is objective, based on what the provider finds in the course of the examination.
 
An exam is not a review of systems - these are two different things and not interchangeable. The review of systems consists of questions that a provider asks about what symptoms a patient has been experiencing. A mental status exam would consist of the provider's documented observations of the patient. The ROS is subjective, based on patient responses; the exam is objective, based on what the provider finds in the course of the examination.
Hi, ok so for Psychiatry coding E&M for new patient (99201-205), if no ROS is done, my coding comes in low even when the time spent is an hour and the Mental Status Exam is complete/thorough. Am I missing a piece here?
 
Hi, ok so for Psychiatry coding E&M for new patient (99201-205), if no ROS is done, my coding comes in low even when the time spent is an hour and the Mental Status Exam is complete/thorough. Am I missing a piece here?

Yes, without a ROS, you will only have a problem-focused history and the code will be low since 3 out of 3 elements are required for new patients. Keep in mind, though, that codes 99201-99205 are for medical management, and are not specific to psychiatric examinations. If that's the case, I would expect the provider is conducting some kind of ROS to evaluate the effects of the patient's medical treatment, or is likely having the patient complete a ROS on the intake paperwork, so they just need to document this. If they are simply doing a psychiatric service only, perhaps this may be more appropriately coded with 90791-90792?
 
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