Wiki Need help Using 90791/90792 just to provide feedback to parents

[mccormickb1]

I am new to behavioral health coding. Our psychologist provide services to pediatric patients. They perform a psychiatric diagnostic evaluation on day 1- meeting and interviewing the child, then interview parent(s) separate and then parent with child together. May also order and have performed same date of service psychiatric testing. The have sent out questionnaires prior to the first visit to parents and teachers. The complete their report and recommendations usually on that date of service. They bring the parents back a week or 2 later to provide only the results of the evaluation, the patient is not usually with them. They believe they can bill 90791 for the day the evaluation is performed and again on the date they meet with the parents. even though the code can be billed once a day, you still need to meet medical necessity and documentation requirements, one of which is a mental health assessment/status. Is this allowed or should they bill another code for the feedback day, such as 90887 or 90846 if patient is not at the session , or 90847 if they are (usually adolescents will come to the feedback with the parents).

 

[Cavalier40]

90791 can most likely be billed for the initial encounter with the patient.

I do agree with your instinct that 90791 should not be billed for the follow up with the parents. If they are just giving results, then I believe 90887 is the more appropriate code. If the consult meets AMA time requirements for a 50 minute family session without the patient present, then 90846 is the more appropriate code.

 

[shaunece@avonurgentcare.net]

90791

90791 can only be billed once in a six month period for most insurance carriers... 90887 is interpetation of psychiatric testing results that would be the best choice. 90846 & 7is when the provider meets with the family to discuss how to deal with the indiividual disability. Basically therapy to parents