n2horses
Guest
I work for a pain management doctor who is now performing procedures in office and also in an ASC that payers are beginning to require pre-procedure psych evaluation and clearance for.
The physician would like to contract a LCSW to work in the office part time, under our group NPI, to perform these clearances.
What CPT codes would be appropriate for this service, as an E/M has already been performed by the physician to establish the treatment plan, and he would refer the patient to the in-house provider for further evaluation? Is this even billable? In our state, a LCSW can counsel and evaluate as patient for behavioral health concerns, including addiction treatment and substances abuse. I am aware that certain types of providers are not eligible for Medicare credentialing and contract, so that is something we are considering as well in the decision to bring a provider on board, or to build a network of referral sources. (We have a 6 month wait for patients to get into our current referral source.)
The alternative is to contract with a licensed psychiatrist or psychologist to perform the evaluations. They obviously bill for their own services, but if the provider was in house and under the group contract, what is the best CPT to describe these evaluation services? The provider is not treating the patient during the evaluation, but will be required to prepare a report on the mental status of the patient as it impacts the chronic condition, pain management and likelihood of addiction/substance abuse, etc., and the mental status as it relates to the procedure (pain pumps, spinal cord stimulators, etc.)
Does anyone have a similar experience within a Pain Management practice?
The physician would like to contract a LCSW to work in the office part time, under our group NPI, to perform these clearances.
What CPT codes would be appropriate for this service, as an E/M has already been performed by the physician to establish the treatment plan, and he would refer the patient to the in-house provider for further evaluation? Is this even billable? In our state, a LCSW can counsel and evaluate as patient for behavioral health concerns, including addiction treatment and substances abuse. I am aware that certain types of providers are not eligible for Medicare credentialing and contract, so that is something we are considering as well in the decision to bring a provider on board, or to build a network of referral sources. (We have a 6 month wait for patients to get into our current referral source.)
The alternative is to contract with a licensed psychiatrist or psychologist to perform the evaluations. They obviously bill for their own services, but if the provider was in house and under the group contract, what is the best CPT to describe these evaluation services? The provider is not treating the patient during the evaluation, but will be required to prepare a report on the mental status of the patient as it impacts the chronic condition, pain management and likelihood of addiction/substance abuse, etc., and the mental status as it relates to the procedure (pain pumps, spinal cord stimulators, etc.)
Does anyone have a similar experience within a Pain Management practice?