Wiki Psychiatry billing

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kjferg47

kjferg47

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This is an area I have not had experience in before so I'm looking for any assistance I can get. Is a provider allowed to bill for these codes multiple times on the same DOS?

90816, 90818, 90847 & 90857

They sound to me to be similar to E&M visits but are not in that section of the CPT manual.

Any advice is greatly appreciated. Thank you

Ken
 
Not in E&M section

These are located in the Medicine section of the CPT book and have VERY specific parameters. For example, the difference between 90816 and 90818 is time spent with the pt face-to-face

Run these through the NCCI edit tool on CMS website to see which ones can be billed together..
 
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I have been learning psych billing this week myself! Cpt's 90801, 90804, 90805, and 90862. Regardless what the CPT is saying you can use. These procedure codes are payor driven as well. It's very important to double check with your payor's on what their documentation guidelines are. Not only do you have to have a mini book documented for this but also the patient in some cases are only aloud to have (for example) 6 cpt charges of 90804 in one rolling year from initial date of service.
Then I discovered different payors have different time unit blocks. Example Insurance A will allow the patient to have four 15 minute session's of charge 90804 in one rolling year from date of service. Insurance B will allow the patient to have six 30 minute session's of charge 90804 in one rolling year from date of service. And with the charge 90862 (Med Mngmt) Insurance C will only pay the provider, 4 multiple patients in one hour. After awhile this all gets difficult to keep seperate!
 
Yes, but what we really want to know is, where did you find the tragic little figure you're using as an Avatar. I hope this is not you...
 
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