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Psychiatric services in the ED

  1. Default Psychiatric services in the ED
    Medical Coding Books

    I attended the AAPC Audio-seminar on How to Accurately Code for Professional Services in Emergency Medicine. Unfortunately, I did not have the opportunity to ask a question.

    My question is related to Psychiatric services in the ED. We have child psychiatrists on our clinical faculty who are asked to see patients in the affiliated children's hospital ED. What code is most appropriate for them to bill? Should they bill a consult code (99251-99255), an ED code (99281-99285) or a Psych evaluation (90801)?

    Thank you for your assistance.


  2. #2
    Louisville, KY

    The ED codes are likely inappropriate. However, if an ER provider does not see/treat the patient, your psychiatrists may be able to use the 99281-5 series.

    The consults can be appropriate, given that the psychiatrists are meeting the criteria: there's a request, a rendering of opinion & report furnished to the attending provider/service.

    90801-90802 may be appropriate in certain circumstances where a full psychiatric evaluation takes place. I'd really expect the ED/ER encounter to be a little less than a complete psych workup--think of the brief nature of those patient visits. Either the patient would be admitted for further work-up with a psych eval or referred to OP for that workup. This, however, is not absolute.

    Lastly, if your psychiatrists admit the patient to Obs status the 99218 series is appropriate or for full admission the 99221 series.

    Please review previous posts in the Behavioral Health area of this forum for greater explanations of the psych evals.

    Good luck & I hope this helps.

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