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Thread: 90862 & 90801

  1. #1

    Default 90862 & 90801

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    Hi. I am new to coding and have a question on billing for a psychiatrist in our group. He saw a patient in his office in the a.m. and billed 90862. Then the patient left and went to another doctor's office (mistakenly thinking she had an appt - Gen Practice). Due to some activity after leaving there, the patient was admitted to the hospital for psyc, and the same psychiatrist did the evaluation (90801). Can both of these codes be billed the same day for the same physician, given that they were independent of one another?

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    Quote Originally Posted by maycricket View Post
    Hi. I am new to coding and have a question on billing for a psychiatrist in our group. He saw a patient in his office in the a.m. and billed 90862. Then the patient left and went to another doctor's office (mistakenly thinking she had an appt - Gen Practice). Due to some activity after leaving there, the patient was admitted to the hospital for psyc, and the same psychiatrist did the evaluation (90801). Can both of these codes be billed the same day for the same physician, given that they were independent of one another?
    As is the rule with most E/M codes, when the patient is seen in the office and then admitted to the hospital later that same day, you may only bill the hospital code. But you can use the documentation from the office visit when choosing the correct hospital code to use, if appropriate. When you check these codes in the CCI edits, 90862 is included in 90801 and cannot be unbundled with a modifier.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3

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    Thanks, Arlene!!

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