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child and parent(s) therapy

  1. #1
    Default child and parent(s) therapy
    Medical Coding Books
    I am new to Behavioral Health coding. I have been trying to research information online. During my searches, I found the following:

    http://www.aacap.org/cs/root/member_...cpt_codes_faqs

    I am especially interested in this Q/A:

    "Q: Which CPT code should I use if I split a single psychotherapy session between seeing a child alone and seeing the parents alone?

    A: If the parents were seen for child-related content (i.e., inclusive of information about the child's condition or treatment, and exclusive of marital or other concerns) then the entire visit can be coded as face-to-face psychotherapy with the child."

    This is not the way my facility has been coding such visits. They have been coding an individual visit for the child (90804-90808, 90810-90815), then 90846-59. Is anyone else using just one code? If so, would this also apply to 90847 [if the provider sees the child alone and then together with the parent(s)]? I have not been able to locate any supporting documentation to use just one code.

    Thank you for any assistance.

    Michelle

  2. #2
    Default
    How much time is the dr really spending with parents?

  3. #3
    Default
    In an hour long session, sometimes the provider will split the time between the client and the client's parent(s). Sometimes, it's for only 10 minutes.

  4. #4
    Default
    I dont know what to say now. We always code just the child therapy code, but you have me wondering if maybe we shouldn't be coding both...CCI edits do allow it, so theoretically they should both get paid.

  5. #5
    Location
    Jacksonville River City FL
    Posts
    22
    Default
    We only bill one psychotherapy code per date of service when there's only one provider rendering services.

  6. #6
    Default
    I think most times, the intent of visit is just regular therapy. I think they talk to parents to gather info as apposed to family therapy without child present. In which case I would say just the child tx should be billed

  7. Default
    It depends on the intent and content of the time spent with the family. If the time spent with the family is part of the pre- or post-service work of the individual therapy, then it would not be separately reported. You would select the code for the individual therapy based on the time spent with the face-to-face with the patient. If the time spent with the family is a separate visit (which just happens to occur on the same day) that meets the criteria for family psychotherapy, then it can be reported separately.

    One of my docs has this come up a few times - juggling schedules for the patient and the parents can be tough. So far I have not had a denial or a request for documentation, but I would not be surprised if the carrier asks for the documentation.

  8. #8
    Default
    Thanks to everyone for your responses. I think my biggest problem is lack of documentation as to what is being discussed during "family therapy". I have some examples of visits I've seen, if everyone doesn't mind giving me their opinion:

    1. The child is seen first for 30 minutes, then the parent(s) is seen alone for 20 minutes for a total of 50 minutes spent discussing the child (no family therapy).

    2. The child is seen first for 30 minutes, then the parent(s) is seen with the child for an additional 20 minutes (again, no family therapy) for a total of 50 minutes.

    3. Parent(s) is seen alone for 30 minutes without the child (child was not present for visit). Again, the discussion is only about the child.

    I'm just totally about whether the time can be added together for the code assignment!

  9. #9
    Location
    Jacksonville River City FL
    Posts
    22
    Default
    We would bill 90806 for the first two scenarios, and 90846 for the third because the child was not present for any part. We would also use 90846-7 if the focus was on divorce or step-parent issue affecting the entire family, how child's difficulties are affecting siblings, etc.

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