Coding > Coding

2013 mental health codes

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Angie:
Just so I am clear:
If my psychiatrist does both on the same day he is going to have to break it out and have one charge for the therapy portion and one charge for med mang. Correct? They will have to be two separate services pretty much; two line items on the claim; even if most of it is therapy and maybe 10 minutes is med mang.
It will not be covered because most insurance companies only cover 1 session per day!

PMRNC:

--- Quote ---Just so I am clear:
If my psychiatrist does both on the same day he is going to have to break it out and have one charge for the therapy portion and one charge for med mang. Correct? They will have to be two separate services pretty much; two line items on the claim; even if most of it is therapy and maybe 10 minutes is med mang.
It will not be covered because most insurance companies only cover 1 session per day!
--- End quote ---

Correct. If your psychiatrist had never used E/M codes it would be a good idea to put a fee schedule together to cover the appropriate E/M codes. I've always advised my psychiatrists to utilize E/M when documentation substantiates it so this is not news for them, they are just now going to have to use the add/on therapy codes when necessary. Mostly therapists and non psychiatrists will have the hardest trouble with the new coding method.

Angie:
He is an M.D. Psychiatrist and no he has not been using the E/M so yes this is a change!
Where on the CMS 1500 form do you put the add on code? I'm confused.....obviously!
Example:
He does med mang 20 minutes on 1/1/13 and in that same session he does 30 minutes of psychotherapy (90833).
Would you put them on a separate line item on the claim form?

PMRNC:
Each CPT Code will be on it's own line. Your E/M will be on one line, and your Add on code will be on the next line. E/M code would come first. Not sure it matters but that's way I was always taught.

The providers med management services would be a part of the E/M appropriate for that visit and of course documented. The Add on code for psychotherapy would then go on the next line depending on the time, for your example would be the 90833 (30 min or 16-37 min)

wbh:
Just curious does anyone know if you bill a 99213, 99214 or 99215 by themselves, are they considered the old Med management codes as in they are not usually counted against a patients therapy visit limit? Or are they considered a therapy visit used with the add-on codes?  If billing a 99 code w/an add on code does that make it a therapy visit and it goes against a patient's therapy visit limit?

Also the 90837 replaces the 90808, did the 90808 require a special authorization from insurances & if yes, will the 90837 now require a special authorization too?

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