Coding > Coding
2013 mental health codes
PMRNC:
They don't have to follow same rules in regards to coding. Even some TPA's are a year or more behind with codes. HOWEVER.. don't quote me on this.. but if you bill out CURRENT codes..they can't deny, it may HOLD the claim up but I do NOT think they can deny for using old codes.
Michele:
Great info! There is already so much confusion! We are in the process of updating our mental health book as well but the info out there is contradicting. We want to make sure we get it all correct. Even the insurance companies don't know all of the new rules!
PMRNC:
They really are not as confusing as people think. A few changes to the Superbills and NON psychiatrists will need some help getting used to E/M :)
ledwards:
in the CPT code book under the Psychotherapy topic it states " some psychiatric patients receive a medical evaluation and psychotherapy on the same day by the same physician or other qualified health care professional." Does this mean a psychiatrist and see the patients for e/? services and a LPC provide the therapy???? 99212 and 90833 to be billed together with two different providers???
PMRNC:
When you look at the new coding descriptors you will notice they no longer say "with pharmacologic management (med management)" When you see, instead "with medical services" that is what is being done, meds are involved to treat the medical portion of the visit's reason. Your LPC will NOT be able to use E/M at all. MOST (actually probably all) plans never allowed more than one visit a day, so IF you have two providers (one for the med management only) and one for the therapy, you will want to check with the carriers to see how that would work. Formerly a psychiatrist could bill a 90862 which included not just med management but "minimal therapy". If the services are going to be broken out to accommodate the licensing requirements of, for example, an LPC, they will be only be able to bill for the therapy and the prescribing physician/therapist (Therapists in NM and LA, can prescribe meds) will ONLY be able to bill the appropriate E/M.
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