June 2, 2013

Mental Health Billing and Psychiatry CPT Code Changes

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For Mental Health care billing codes, there have been major changes in Psychiatry CPT Coding in 2013, thereby considerably changing the billing and documentation for all insurances.

The Psychiatry CPT Code Changes have brought huge distinction between initial evaluation of medical services done by a physician 90792 and evaluation done by a non Physician 90791.
Mental Health Billing and Psychiatry CPT Code Changes
Psychotherapy codes have been simplified and expanded to include time with both the patient and/or family member. In 2013 there will only be three timed codes to be used in psychotherapy (90832-30minutes; 90834-45minutes; 90837-60minutes).

Mental Health Psychiatry CPT Changes

According to Mental Health Billing and Psychiatry CPT Code changes, whenever psychotherapy is done in the same encounter as an E/M service there will be timed add-on codes for the psychotherapy that will be used by psychotherapist to indicate both services were provided; the codes to be used in this case will be (90833-30minutes, 90836-45minutes, and 90838-60minutes).

The only CPT codes that are not changing are:
  • 90845 Psychoanalysis
  • 90846 Family Therapy-Patient not present
  • 90847 Family Therapy-Patient Present
  • 90849 Multi-Family Group Treatment
  • 90853 Group Therapy
The time for each psychotherapy will be described as being time spent with the patient or family member in contrast to the previous psychotherapy code times which only denoted time spent face to face with a patient.

Psychiatry add-on CPT Code

There is an add-on code that will cater for scenarios where a patient encounter is made more complex by the involvement of other people other than the patient (90785). This add on code will be used with initial evaluation codes (90791 and 90792).

This code is expected to be used more often with children. There is an interactive manual that clearly stipulates what constitutes an interactive complexity. This code should be followed with a documentation to clearly indicate the complexity at hand.

Psychiatric CPT changes for 2013

90839 is another code that has been added in the Psychiatric CPT changes for 2013. This code will essentially be used whenever an encounter goes beyond the maximum 60 minutes.

The add-on code for each additional code in this case will be 30 minutes. This code was developed upon a request by the National Association of social workers. Psychiatrists will use this code when administering high level evaluation management. There is a manual guideline that clearly stipulates how this code should be used and when it will be used

Psychotherapy Medication CPT Codes

Code 90862 has all but been faced out and psychiatrists in this case will be required to use appropriate evaluation and management code whenever they perform pharmacological management of the patients.

A new add-on code has +90863 been added in the CPT psychiatric that will solely be used for medication management whenever a psychotherapy is done by a psychotherapist.

Some of the changes that are to be seen in the CPT Psychiatry include:
  1. Removal of evaluation and management (E&M) plus psychotherapy codes from the psychiatry section (90805, 90807).
  2. Deletion of pharmacologic management (providers to use appropriate E&M code).
  3. Psychotherapy and E&M services are distinguished from each other (time spent on E&M services is not counted towards psychotherapeutic services, and separate codes can be used in combination with one another).
  4. Inclusion of add on codes for psychiatry, which are services performed in addition to a primary service or procedure (and never as a stand-alone service).
  5. Addition of code 90785 for interactive complexity.
  6. New code for psychotherapy for a patient in crisis.
These CPT changes clearly stipulate that insurers including Medicare and Mediacaid cannot use codes that have been deleted by AMA. They can only make pricing and coverage decisions within the remaining and modified codes.

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