Psychotherapy twice on same day?

laurabee

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I'm coding for a residential mental health facility. A patient was seen in the morning for a 45 minute psychotherapy session by an LPC, and because of his level of distress (not qualifying for crisis intervention coding), the LPC met with him again in the evening for 30 minutes to follow up. I'm aware that a provider billing for two psychotherapy sessions in the same day is not allowed, but is there any way to be reimbursed for this that I may not be aware of? I'm fairly new to mental health coding, so I'm triple checking my research to CMA and any help would be appreciated! :p
 

cdeak01

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Not knowing the circumstances of the first visit, would the patient qualify for interactive complexity 90785, in addition to the psychotherapy?
 

MJ4ever

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Psychotherapy

I'm coding for a residential mental health facility. A patient was seen in the morning for a 45 minute psychotherapy session by an LPC, and because of his level of distress (not qualifying for crisis intervention coding), the LPC met with him again in the evening for 30 minutes to follow up. I'm aware that a provider billing for two psychotherapy sessions in the same day is not allowed, but is there any way to be reimbursed for this that I may not be aware of? I'm fairly new to mental health coding, so I'm triple checking my research to CMA and any help would be appreciated! :p



Hi Laura,
https://www.cgsmedicare.com/pdf/psychotherapy_checklist.pdf

Since I can't see the documentation to be sure what was provided in the afternoon session, let me give some outcome scenarios.
If two psychotherapy sessions took place on the same day, you would add the two and code one claim with the combined time. Since it is 90 minutes, you would code 90837.
Look at the attachment for documentation requirements though. The documentation on both needs total time, type of therapy (individual), therapeutic technique used and content of the session to show how the provider helped to alliviate the patient's condition.

Let's say the morning session included all the documentation requirements for therapy but the afternoon did not, then you could only code therapy for 45 minutes and the afternoon as a H0046.
The other person talked about interactive complexity 90875. Not sure if you know what this is for. It is listed at the end of page 2.

Also, let's say for future scenarios... If this happens again and the total goes to 2 hours, then you could code 90837 for the first 60 minutes and 99354 for prolonged service for the second hour.

Hope this helps,

Barbara
 
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