Author Topic: e/m code with add on codes  (Read 2765 times)

jessika1803

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e/m code with add on codes
« on: March 26, 2013, 12:41:57 PM »
I'm trying to understand these E/m codes with the add on therapy codes and how they work.
for example the 90833 is 30min therapy, if a psychiatrist uses this code and does a 99214 does that equal out to be a 55 min sessions. Are the times separate?

or does it work as they were in a session for 30 minutes we use the 30minute therapy session with the appropriate e/m code with the times being combined?
i hope this makes sense any help would be greatly appreciated. We have new pschiatrists on staff and I am trying to understand this new method with the add on codes.

PMRNC

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Re: e/m code with add on codes
« Reply #1 on: March 26, 2013, 03:57:16 PM »
First you want to make sure your client/provider is doing the coding and it's matching documentation.
The E/M code is for the med management, if they are NOT doing med management and therapy only they will NOT use the E/M Code (prescribers only)
You want the provider to understand the diff elements of the E/M codes.  The therapy codes are for therapy only.
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Billergirlnyc

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Re: e/m code with add on codes
« Reply #2 on: March 26, 2013, 04:07:48 PM »
E/M code isn't based on time only. I asked one of my billers (she has a background in mental health billing) about these codes and she sent me this link that she thinks you should be looking at for 2013, released by the APA. It gives deleted codes and what the new add-on psychotherapy codes to E/M mean, and what scenarios constitutes billing them, etc. I only glanced at the pdf's but they seem pretty informative. It has detailed info on the 90833 add-on psychotherapy code when done with E/M. Hope this helps you.

http://www.psychiatry.org/cptcodingchanges - scroll down and under "the basics" click those pdfs and download. Be sure you download the changes for 2013 pdf and the 2012-2013 CPT Codes Crosswalks pdf.
« Last Edit: March 26, 2013, 04:21:06 PM by Billergirlnyc »
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PMRNC

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Re: e/m code with add on codes
« Reply #3 on: March 26, 2013, 06:03:28 PM »
For the new mental health codes, only prescribers are going to use the E/M codes IF THERE IS medical services being rendered apart form psychotherapy. PER the APA guidelines:   
Appropriate E/M code (not selected on basis of time), and
+90833, 30 minute psychotherapy add on code

Prescribers who are not used to using E/M codes (they always could before this new rule) will need to get into the habit of watching TIME in their documentation.. NOT for the E/M but for therapy. If the provider saw the patient for 30 min of only therapy they can only bill the 90833.   If the provided additional time in medical management (mostly pharmacological management) they need to now break that down.   

The reason I said you need to look at documentation is that you won't know if there were medical services being rendered if it wasn't documented. (Not documented, not done)

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com