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2 90801 with in same practice

  1. #1
    Question 2 90801 with in same practice
    Medical Coding Books
    I was wondering if you can bill a 90801 for the same pt within the same group. This was within 2 months of each other. One provider is a CNS who handles the meds and the other is Psychologist who did another evaluation.
    My understanding is that the 90801 code be treated as a new pt thing and the 2nd provider who seen the pt in the group should be going off her evaluation or am I way off?
    I also think the CNS should be billing an 99404 which is a med management Diagnostic Eval per MA Medicaid MBHP plan, per there fee schedule.
    Any help would be appreciated.
    MonaLisa LaBonte CPC

  2. #2
    both providers are different specialty therefore can both bill it. Especially after 2 months. Alot can change in that time with a psych patient

  3. Default
    We bill a new 90801 for the same patient if there is a minimum time gap of 6 months or for a lesser time gap if this second evaluation is for severe exacerbation of the psychiatric illness
    Jagadish, CCS-P, CPC

  4. #4
    is this ok on the same day?
    MonaLisa LaBonte CPC

  5. #5
    I dont know for sure. I dont think I have had 2 in one day. I think I would try to avoid it if possible.

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