Author Topic: 2013 mental health codes  (Read 16732 times)

PMRNC

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Re: 2013 mental health codes
« Reply #15 on: December 03, 2012, 03:56:34 PM »
It's just going to be on a separate line item.
Linda Walker
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Angie

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Re: 2013 mental health codes
« Reply #16 on: December 04, 2012, 08:34:56 AM »
So if his charge for 90819 is $220 he is going to have to split his charges out now?
90819 one charge and 90836 a different charge?
Because as of now his 90819 for $220 is for both psychotherapy w/ E/M......

Angie

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Re: 2013 mental health codes
« Reply #17 on: December 06, 2012, 08:32:36 AM »
So if his charge for 90819 is $220 he is going to have to split his charges out now?
90819 one charge and 90836 a different charge?
Because as of now his 90819 for $220 is for both psychotherapy w/ E/M......

PMRNC

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Re: 2013 mental health codes
« Reply #18 on: December 06, 2012, 09:05:06 AM »
With psychiatry, remember that physicians (prescribers/MD) have always been able to bill an E/M code as long as the documentation supported all elements of that E/M code.   For 2013 they took away the 90862 (med management) and instead physicians will bill the appropriate E/M code :  99204-99215 (outpatient)  99222-99233 (Inpatient)

90819 will cross walk to 90836 (45 min psychotherapy)      NOW if the physician is billing medication management they will use the appropriate E/M code, making sure that documentation supports all the elements of that E/M code.   It's important to note that the E/M you are using is not selected based on time because your psychotherapy code (90836, in this case) is based on 60 min. 

Now if your provider is ONLY providing medication management (NO THERAPY AT ALL) previously this was HCPCS code of M0064 (MED mgmt services only)   That will then say you can use the appropriate E/M code as long as documentation is there to show the elements of that E/M   

As for the use of modifiers you will follow the same guidelines as always when appending the appropriate and needed modifier to the E/M.    It looks confusing because many psychiatrists never really knew they COULD use E/M codes before but really all that has changed is the addition of therapy and breaking out the therapy FROM the med management.     If your provider is ONLY doing therapy they will ONLY use the Therapy codes.
Linda Walker
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Angie

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Re: 2013 mental health codes
« Reply #19 on: December 06, 2012, 10:17:58 AM »
Thanks Linda. Still a little confused on the whole E/M because he never really used them before so I will do some further research into that. He has always just used the same codes 90819 coding family.......
What is the difference in the new CPT coding book from the professional or standard? Is there a difference in the one you purchase?

PMRNC

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Re: 2013 mental health codes
« Reply #20 on: December 06, 2012, 01:08:50 PM »
I just get the spiral edition each year. I also get the specialty cards which is laminated and comes in handy for specific specialties.
Linda Walker
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rdmoore2003

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Re: 2013 mental health codes
« Reply #21 on: December 17, 2012, 10:22:57 AM »
Are you billing for a psychiatrist who is doing medication management and also psychotherapy?  If so then you may want to look at the 25 modifier to indicate the E&M, 99214, is separate from the psychotherapy.  If you are billing for a psychologist or LCSW I don't believe the 99214 & 90833 would be appropriate together.

Thank you.   I bill for a Medical Psychologist and LPC's.   The M.P. does have rx rights.
Regina

rdmoore2003

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Re: 2013 mental health codes
« Reply #22 on: December 17, 2012, 10:29:59 AM »
my only confusion now is since my medical psychologist (only 2 states have medical psychologists) now will be using e/m codes for his medication visits with therapy, are we to split the costs between the 2 codes?

example: say old code 90805, we charged $127.00
new codes will be say 99213 +90833, do we split the original $127.00 between the 2 codes or have an amount for each code?   and with these new codes, will I need to use 25 modifier on e/m code?
Regina

rdmoore2003

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Re: 2013 mental health codes
« Reply #23 on: December 17, 2012, 10:30:53 AM »
sorry, 1 more thing.   is the moo64 code still going to be used?
Regina

Michele

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Re: 2013 mental health codes
« Reply #24 on: December 19, 2012, 09:05:42 AM »
I believe you would need the 25 modifier.  As for the charges, the provider should set a fee schedule for each new code based on what that code is worth.  I wouldn't just 'split the fee' of the old code.
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rdmoore2003

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Re: 2013 mental health codes
« Reply #25 on: December 19, 2012, 09:57:24 AM »
Thank you.   I participated in a webinar yesterday.  25 modifiers are not to be used since they are add on codes.  What a mess!!
Regina

PMRNC

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Re: 2013 mental health codes
« Reply #26 on: December 19, 2012, 09:57:34 AM »
I agree with Michele, this is biggest challenge for the prescribing NON psychiatrist, I suggest additional resources for him or her for eval and management. You will also want to create fee schedules for these codes.   The use of modifier 25 however I'm still trying to find out because why would you need it when the mental health therapy codes are "add" on's and already show the medication management part of the E/M IN it billed along with a therapy code (Why the hell do they mess with stuff that works??)   

As for M0064, that was a HCPCS only to be used for Psychiatrists who for NO other purpose saw patient regarding meds, maybe quick dosage check or adjustment, I don't believe it was ever payable to psychologists. They mainly created that code to prevent overcharging/fraud that mostly goes on for inpatient treatment and nursing home visits.
Linda Walker
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PMRNC

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Re: 2013 mental health codes
« Reply #27 on: December 19, 2012, 10:00:59 AM »

Quote
Thank you.   I participated in a webinar yesterday.  25 modifiers are not to be used since they are add on codes.  What a mess!!

I see you typed that before I finished my post :)  I agree. .MESS.    one of my clients did a mini meet with some colleages to which I sat in on and he said same thing.. don't need modifier 25. Modifier 25 was never used anyway to affect reimbursement so now that we have the add on codes for the E/M wouldn't need modifier 25.. YOU WOULD THINK.. however..      I took an online webinar class where they say it should be appended to the E/M  :o :o :o :o  I wrote to them and see what they say.   I took a LOT of notes so I'm trying to find a way to upload them to our mental health area. As there is going to be MASS confusion.. especially for your psychologists who are not used to using E/M
Linda Walker
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rdmoore2003

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Re: 2013 mental health codes
« Reply #28 on: December 19, 2012, 10:15:45 AM »
thanks Linda.   Years ago, I transferred over to mental health with psychologists and LPC's to get away from E/M codes.  Well, I enjoyed it while it lasted....
Regina

rdmoore2003

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Re: 2013 mental health codes
« Reply #29 on: December 19, 2012, 10:17:39 AM »
I contacted my state workers compensation yesterday.   It is a shame, that my state has not updated cpt codes since 2001.  Why is it that state w/c does not have to follow same updates/laws as all others?   They do not have any plans on updating for 2013 codes, either.
Regina