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jcochran

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So, I have a very perplexing coding dilemma and am hoping for some insight/suggestions.

We were recently referred a client who had been hospitalized for suicide attempt/MDD/OCD.

He was sent straight over to our office upon discharge from the hospital for immediate eval/treatment.

Was initially scheduled with a psychologist, but was then referred by that psychologist to one of our psychiatrists. This was very late on a Friday afternoon; client was seen on an urgent basis.

Client arrived late t the appointment, however our MD saw him on an urgent basis anyway, and then had him come back in the following Wednesday.

When the M.D. wrote the report, he did a single report for both days (ugh!!).

There was a total of 160 minutes spent with this client face to face, who is a very severe case, (and with additional time spent in coordination of care/research on case/reviewing records), I am unsure how to code this. Any ideas?

Also, this client has out of network insurance (double ugh!!) and we were given authorization for 1 99205, however, were not given authorization for an emergent or extended visit.

Please help? Do I code 2 separate visits even though they are technically part of the same eval and are done on the same report? Or do I code for only 1 visit?

~confused
I posted this in general forum as well-
 
So, I have a very perplexing coding dilemma and am hoping for some insight/suggestions.

We were recently referred a client who had been hospitalized for suicide attempt/MDD/OCD.

He was sent straight over to our office upon discharge from the hospital for immediate eval/treatment.

Was initially scheduled with a psychologist, but was then referred by that psychologist to one of our psychiatrists. This was very late on a Friday afternoon; client was seen on an urgent basis.

Client arrived late t the appointment, however our MD saw him on an urgent basis anyway, and then had him come back in the following Wednesday.

When the M.D. wrote the report, he did a single report for both days (ugh!!).

There was a total of 160 minutes spent with this client face to face, who is a very severe case, (and with additional time spent in coordination of care/research on case/reviewing records), I am unsure how to code this. Any ideas?

Also, this client has out of network insurance (double ugh!!) and we were given authorization for 1 99205, however, were not given authorization for an emergent or extended visit.

Please help? Do I code 2 separate visits even though they are technically part of the same eval and are done on the same report? Or do I code for only 1 visit?

~confused
I posted this in general forum as well-

Well if what you have is authorization for 99205..and it sounds like the time element meets that criteria, I would bill that code 1 time for both days. Your other option is to contact the insurance, explain the circumstances and ask for authorization for extended services so you could bill for each day. You may have to submit documentation so depends on how that looks.
 
Last edited:
Thanks so much, we reqeusted add'l auth and were denied.... ugh. I guess 99205 it is:(

I appreicate your feedback, thanks!
 
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