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Psych coding - E&M Codes

  1. #1
    Location
    South Salt Lake
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    13
    Default Psych coding - E&M Codes
    Medical Coding Books
    Hi everyone- Could any of you Psych coders tell me whether you/your Dr is coding with the psych codes 908__ or the E&M Codes 99201-99215? My Dr read an article indicating that the better reimbursements are with the E&M codes. I explained that he still needed to meet the E&M criteria, but when I read some of the info at the AACAP it states that if it is for a psychotherapy session you should use the 908__ codes. Anyone have any input on this? Thanks so much
    DSheppick

  2. #2
    Location
    Tacoma, WA
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    1,087
    Default
    Quote Originally Posted by dixiesheppick View Post
    Hi everyone- Could any of you Psych coders tell me whether you/your Dr is coding with the psych codes 908__ or the E&M Codes 99201-99215? My Dr read an article indicating that the better reimbursements are with the E&M codes. I explained that he still needed to meet the E&M criteria, but when I read some of the info at the AACAP it states that if it is for a psychotherapy session you should use the 908__ codes. Anyone have any input on this? Thanks so much
    The E/M codes 99201-99215 could be used if the doctor documented the appropriate bullet points found in the 1997 E/M guidelines. You can pull those up on the CMS website and go the to documentation for Psychiatric Examination. There are very clear directions for documentation there.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Louisville, KY
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    1,101
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    Are there very many psychiatrists who even conduct psychotherapy on an outpatient basis any longer? If so, they are a dying breed. In my experience, psychiatrists (or their nurse practitioners) perform medication management services, but delegate therapy to LCSW, PhD or PsyD (sometimes outside the practice).

    If it is medication management, I would not feel comfortable assigning an E&M code, when 90862 was specifically designed for that service. If, indeed, the provider is conducting psychotherapy, I'd default to the 908XX series, as typical E&M do not account for psychotherapy. Be mindful that 90862 includes minimal psychotherapy . . .

  4. #4
    Location
    South Salt Lake
    Posts
    13
    Default code 90801 feedback
    Thanks for your input, yes our Dr does do the psychotherapy, he has been using the 908xx codes, I think we better just stick with those. He asked another question regarding 90801, he wanted to know if he can modify for extra time spent with the patient. Has anyone had any experience with that?
    DSheppick

  5. #5
    Location
    Louisville, KY
    Posts
    1,101
    Default
    The code (90801) is not time based, so no, additional time cannot be billed.

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