Wiki Psych Visit Coding

[hfisher09]

I had a patient come into my office for a 99213 with a PA. Said patient ended here for 45 minutes and a crisis team was called. Can we be a 90836 and 90785?


Thanks

 

[SharonCollachi]

If psychotherapy was performed by the PA, then you can bill the add on code 90836. Why do you think a 90785 is warranted? I'm not seeing it on the information presented.

 

[Pam Warren]

I wouldn't bill psychotherapy for a mid-level provider. Generally speaking, psychotherapy codes are billable by mental health providers; social workers, psychologists and occasionally psychiatrists. Often, psychotherapy codes require pre-certificaiton, and you may get a denial if billed by a PA. In this case, bill the E&M code that most closely matches the level of service, by time if it's documented.

 

[SharonCollachi]

When I was working in mental health, we had PAs and NPs that had mental health specialties. I wouldn't rule out psychotherapy on that basis alone, that's why I said "if psychotherapy was performed". Preauthorizations are another matter (although when I left mental health, we were at the point where very few insurances were requiring auths for routine outpatient psychotherapy).

 

[Lynda72]

Can codes 99214 and 90785 be billed together? Thanks,

 

[huggarat2]

Can codes 99214 and 90785 be billed together? Thanks,

No, the 90785 is only billable with psychotherapy codes 90791-90838. If the provider feels there was more complexity to the encounter, they should bill the service based on time for E/M codes.

 

[Knapp007]

Can codes 99214 and 90785 be billed together? Thanks,

You can bill a 90833 with the 99214 that helps with reimbursement

 

[spalac4@wgu.edu]

Hello everyone,

I have a question. I understand that 90791 cannot be billed in conjunction with an e/m by the same individual. Does that mean all the providers in the same office? or just an individual?