Coding > Coding

Group Therapy

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CMorgan:
What is the difference between 90853 and H0005? How do I know which code to use when billing for Group Therapy sessions?

Michele:
90853 is the cpt code for group therapy, regardless of the diagnosis.

H0005 is the HCPCS code for Alcohol and/or drug services; group counseling by a clinician

Christy:
this is similar to my therapy vs substance abuse thread question.


using this question as an example, assuming that the group is discussing their addictions with a private mental health provider, in an office setting which code is more appropriate?

PMRNC:
MANY therapists/counselors specialize in Dual diagnosis.. so let's say you have a patient with opiate abuse and they maintain dx of bipolar or anxiety.. The service is coded by the actual "MEAT" of the therapy and the focus of the therapy. So if a patient has a history of abuse/addiction of opiates, they may receive counseling for substance abuse with secondary dx (dual dx).

IT depends ON THe services the provider is rendering.. if they are rendering psychotherapy with the primary dx of a mental health issue it should be coded appropriately as psychotherapy. If your provider is rendering a group session for alcohol/drug .. it's coded appropriately with the appropriate dx code for alcohol and substance abuse.

I have clients who do BOTH.. they should be clearly documented in the chart. You also don't want to bill BOTH for same date of service as most carriers will NOT pay for two sessions in one day.

Wendy2015:
Am also looking for a similar code for IOP. Is the H0005 code based on time? I am looking for a code to bill IOP 3 hours a day 3 times a week.

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