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Psychiatric interview exam

  1. #1
    Default Psychiatric interview exam
    Medical Coding Books
    We have a provider assigning modifier 22 to code 90801 when the procedure takes an hr or more. Would you think this is acceptable? and where are you finding the written documentation on this. Thanks
    Last edited by Jenny8675309; 04-02-2010 at 09:13 AM.

  2. #2
    Location
    Bridgeport, CT
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    No, modifier 22 should never be appended to an E/M code. As there is no time associated with CPT 90801, you would also not be able to report prolonged services either.
    Sorry!

  3. #3
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    90801 is a procedure (CPT) code, not an E&M. The general rule of thumb is that an initial intake lasts 45-60 minutes. Time spent over 60 minutes can have a -22 appended to it, but documentation must support the extra time spent. Check the CPT Coding for Psychiatry book.

  4. #4
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    Quote Originally Posted by MMaine View Post
    90801 is a procedure (CPT) code, not an E&M. The general rule of thumb is that an initial intake lasts 45-60 minutes. Time spent over 60 minutes can have a -22 appended to it, but documentation must support the extra time spent. Check the CPT Coding for Psychiatry book.
    I disagree. How can a code with no time limits have a modifier 22 appended to indicate more than 60 min spent? No where in the CPT book does it say 90801=60 min

  5. #5
    Location
    Columbia, MO
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    12,843
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    I too say no to the use of the 22 modifier in this instance. There is no time demension for this code. In my CPT book under the instructions for psych codes it states that the 52 or 22 modifiers may be used to reort services that were less or more lengthy than the TIME BASED CPT codes define. As already stated there is no time definition for 90801 so there is no determination of when the service is more extensive.

    Debra A. Mitchell, MSPH, CPC-H

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