There are other articles on CodingIntel about the difference between new and established patients, and the rules haven’t changed, but that doesn’t mean it is always clear. This article is here to try and clarify any remaining questions you have about the differences. Medicare definition “Interpret the phrase “new patient” to mean a patient who […]
Archives for June 2019
Psychotherapy Codes
Individual psychotherapy codes are time based codes. One set may be reported as a stand alone service, and another during the same visit as medication management. They follow the CPT®; time rule: use the code when the mid-point in the defined time is met. The CPT®book itself lists the time thresholds at the start of […]
Psychotherapy for Patients in Crisis
90839 Psychotherapy for crisis; first 60 minutes. +90840 each additional 30 minutes 90839 is the code for psychotherapy for crisis; first 60 minutes. 90840 is an add-on code for each additional 30 minutes of time spent with a patient who is in crisis. These codes do not have CPT® limitations on place of […]
Family and Group Therapy Codes
Group therapy Group psychotherapy is reported with code 90853. This is not a time-based code: one unit of service should be reported for each group member according to CPT®. Group therapy typically lasts 45 to 50 minutes, and some payers set a limit at 12 participants. Many payers require that the number of members in […]
Overview of Diagnosis Coding for Behavioral Health Services
Match diagnoses on the claim form to those listed in assessment The diagnosis codes on the claim form should match those in the note. If the assessment says “stable on medications” or “doing well,” it isn’t clear how many conditions were managed and treated In the assessment, list conditions managed, their status, and treated Note […]
Psychiatric Diagnostic Evaluation
There are two codes for psychiatric diagnostic evaluation. 90791 Psychiatric diagnostic evaluation 90792 Psychiatric diagnostic evaluation with medical services 90791 is used by psychologists, social workers and other licensed behavioral health professional and 90792 is used by psychiatrists and psychiatric nurse practitioners and physician assistants, because it includes medical services. Here is how CPT® defines […]