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any advice on emergency office visit for psychiatry?

  1. Exclamation any advice on emergency office visit for psychiatry?
    Medical Coding Books
    i had a meeting today and some interesting thoughts where brought up. i was wondering if anyone had any advice, thoughts, or use of codes for a case where a patient has to be seen in an emergency. i wasnt sure if there was an E&M code that could be used in a psychiatry setting that would get paid for such a thing??

  2. #2
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    You would still just bill the regular psych codes for office visit

  3. #3
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    Quote Originally Posted by 1073358 View Post
    You would still just bill the regular psych codes for office visit
    Assuming its during normal clinic hours.

  4. Default
    You didn't say if this was a new patient? Resulting in admit? Was this an initial assessment? Consult? Est patient with an E&M component or just straight psych counseling?

    Just keep in mind a psychiatrist can code the usual 99201-99215 E&M codes and can even code the consult codes 99241-99255 (consult, assuming not m/care patient)

    You will have to determine which range of codes the 992xx vs the 908xx best reports the service that was provided and what is supported by documentation. The reimbursement is different

  5. #5
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    Quote Originally Posted by sbicknell View Post
    You didn't say if this was a new patient? Resulting in admit? Was this an initial assessment? Consult? Est patient with an E&M component or just straight psych counseling?

    Just keep in mind a psychiatrist can code the usual 99201-99215 E&M codes and can even code the consult codes 99241-99255 (consult, assuming not m/care patient)

    You will have to determine which range of codes the 992xx vs the 908xx best reports the service that was provided and what is supported by documentation. The reimbursement is different
    Good point. I have a Dr that only wants the E&M (99214, etc) type codes vs. the Psych (90806, etc) billed when he sees his patients. I can't really find any criteria to direct my Doc one way or the other. Anyone else have a Dr that only wants E&M not Psych? Is there any documentation in case my Doc gets audited that will support (or the opposite, lol) his practices?
    Becki, CPC, CPMA, CGIC, CHONC, COSC, CPCD, Fellow

  6. #6
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    determining em vs 908xx codes can be tricky. My best advice was to determine if he did psychotherapy or not. If yes, bill 908 codes, if no bill EM.

    he wants to bill EM's cause they get paid better and higher RVU

  7. #7
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    Quote Originally Posted by kcostigan View Post
    i had a meeting today and some interesting thoughts where brought up. i was wondering if anyone had any advice, thoughts, or use of codes for a case where a patient has to be seen in an emergency. i wasnt sure if there was an E&M code that could be used in a psychiatry setting that would get paid for such a thing??
    If they are seen in the office in an emergency, I have had psych doc add the 99058 to the visit or counseling level and it was paid.

    Debra A. Mitchell, MSPH, CPC-H

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