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Thread: Inpt Consults for Behavioral Health

  1. #1
    Join Date
    Apr 2007
    Location
    Biloxi, MS
    Posts
    177

    Exclamation Inpt Consults for Behavioral Health

    Promo: Code Books
    One of the people in my office bill for Behavioral Health, and with Medicare no longer paying for Consults she poses a question what to bill in an inpatient setting. Outpatient the Doctors dont do Consults. Any link to documentation to support what to use would be appreciated. She has to answer to someone who has little knowledge and needs proof. You can email me if you would rather. Colleenrcoxmso@hotmail.com
    Thank you,

    Colleen R Cox CPC

  2. #2

    Default

    Look on Medicare website, I know its on there somewhere. I will look tomorrow if I get time

  3. #3

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    I can tell you that she should bill a 99221-99223 rather than the consult. Seems weird I know, but that's what they are telling us to do becuase it is that provider's initial visit with patient. You will have to make sure whoever the attending dr is, that he uses an AI mod on his code

  4. #4
    Join Date
    Apr 2007
    Location
    Biloxi, MS
    Posts
    177

    Default

    Thats what I told the girl in my office, she needs documentation to prove it to the person who puts together her charges. She just does data entry the lady who gets her work together is trying to get her to bill ov codes 99212-99215 for inpt consults.
    Thank you,
    CRC CPC

  5. #5

    Default

    Quote Originally Posted by colleenrcox View Post
    Thats what I told the girl in my office, she needs documentation to prove it to the person who puts together her charges. She just does data entry the lady who gets her work together is trying to get her to bill ov codes 99212-99215 for inpt consults.
    Thank you,
    I would not recommend she do this. It is clear that those are NOT correct codes. Those are for OUTpatient and you are coding IN patient.

    Look on Medicare, this info is all over right now

  6. #6

  7. #7
    Join Date
    Apr 2007
    Location
    Carmel, New York
    Posts
    1,172

    Default Diagnositic Interview?

    Does the service meet the criteria for 90801?

  8. #8
    Join Date
    Apr 2007
    Location
    Biloxi, MS
    Posts
    177

    Default

    Thank you for all your answers. I am asking these questions for a girl who is in the next office. I have done some behavioral health a few years back but have limited knowledge. The last thing I want to do is give her false information. We know not to bill out patient ov for inpatient consults. She askes these questions: For a 90801, can that be in or outpatient? Is it considered a new visit by Medicare? There is not a clear discription in CPT. So of course I am going to ask my fellow coders who specialize.
    CRC CPC

  9. #9

    Default

    Quote Originally Posted by colleenrcox View Post
    Thank you for all your answers. I am asking these questions for a girl who is in the next office. I have done some behavioral health a few years back but have limited knowledge. The last thing I want to do is give her false information. We know not to bill out patient ov for inpatient consults. She askes these questions: For a 90801, can that be in or outpatient? Is it considered a new visit by Medicare? There is not a clear discription in CPT. So of course I am going to ask my fellow coders who specialize.

    Take a look at this, I think it wil help you:
    http://www.wpsmedicare.com/part_b/po...al/index.shtml

    Scroll down to psychiatry services

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