Our Consult service does psych consults in our hospitals emergency room. Billing 99241-99245 GT modifier POS 02, unless medicare we use "G" code and no GT. My question is....In your 1/8/19 Webinar it was stated that **May not bill for Psychiatric Diagnostic Interview exams with medical services or E/M services. My understanding of Psych diag interview is 90791-90792. But you mention WITH e/m visit. Do you mean you can't bill both? Or do you mean any initial psychiatric evaluation? Our patients are see by the E.D. physician so I assume this wouldn't pertain to Consult Psych.. Correct?
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Wiki Telemedicine webinar- Psych diagnostic Interview
- Thread starter elaine.nutt@ohiohealth.com
- Start date
mitchellde
True Blue
As of Jan of 2018 you no longer use the GT modifier for commercial ins use the 95 modifier for Medicare no modifier.
When you say the patient is in the ER then I assume they are in the ER in a qualified originating rural area and you are the distant site provider.
As the provider of the psych service you would not bill an E&M code with the psych assessment code. It does not matter that other providers of other specialties are also billing an E&M.
When you say the patient is in the ER then I assume they are in the ER in a qualified originating rural area and you are the distant site provider.
As the provider of the psych service you would not bill an E&M code with the psych assessment code. It does not matter that other providers of other specialties are also billing an E&M.
Telemed Psych
Telemed code for a psych "consult" initial visit in E.D.? Commercial Insurance... you say we can't bill 99241-99245? and we can't bill 99281-99285. What code would you suggest? or are you saying we cannot see the patient via Telemed for the initial visit? Any documentation on this?
Telemed code for a psych "consult" initial visit in E.D.? Commercial Insurance... you say we can't bill 99241-99245? and we can't bill 99281-99285. What code would you suggest? or are you saying we cannot see the patient via Telemed for the initial visit? Any documentation on this?
mitchellde
True Blue
No that is not what I said. The service must meet the qualifications for telemedicine. Meaning the patient must be located in qualifying rural area or defined professional shortage area. So if the ER where the patient is at the time of service meets this definition then it qualifies as telemedicine. If the ER is in the same locale as the provider then it would not qualify. For commercial insurance you bill ether consult or ER or initial psych whichever the documentation supports with 95 modifier not the GT as of Jan 2018. If the patient is not in a qualifying originating location then your provider would need to go to the ER to see the patient.
You cannot bill a consult or other E&M with the 90792.
You cannot bill a consult or other E&M with the 90792.
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Got it, thank you, Friday afternoon brain fog!