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What/how much EM to bill 90805 vs 90804?

  1. #1
    Default What/how much EM to bill 90805 vs 90804?
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    What do you look for in a note to determine if you should bill therapy with or without EM component? I am curious what others do to determine. I would like examples. If dr mentions meds or changes them, is that enough to consider it with EM? What else do you watch for if anything?

  2. #2
    Hi, I am looking at the BH coding and pymt guide from ingenix and it says you also need to document one or more of the following for E/M component:

    • discussion of any clinical or medical d/o that may be influencing or affecting the patient's psych status
    • any institution or continuation of psych or nonpsych medications
    • any other service requiring an MD or DO licensure

    hope this helps.
    Donna E. Young, CPC

  3. #3
    Great-all the ones that I code EM for are having medicine conversations and adjustments so that means I am on track!

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