CPT New 2013 Mental Health Codes

[TiffanyM]

Psychotherapy Time codes 90832, 30 min 90834 45 min ,90837 60min.

This code/code combination cannot be reported on the same day as a psychotherapy or E/M
service. mental health providers should not billed E/M codes with the time codes above correct..

Thanks,

Tiffany

 

[Laureen]

Hi Tiffany,

That is correct those codes should not be used with EM codes. Their counterparts 90833, 90836 and 90838 are the ones to be used with an EM code.

Here is a great chart to use https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/business_of_practice/cpt/Code_Selection_Algorithm_v3.pdf

 

[TiffanyM]

Thank you - I always like to get your stamp of approval.

 

[Laureen]

Thanks Tiffany - Now if only I could get my husband to want that.

 

[Regina]

Medical Psychologists can use therapy codes with E/M codes. Depending on the carrier, if therapy services are documented along with the medication visit, the codes can be used together.

 

[TiffanyM]

Medical Psychologists can use therapy codes with E/M codes. Depending on the carrier, if therapy services are documented along with the medication visit, the codes can be used together.

Hi Regina, yes they can - but not for the codes listed above.

If there is psychologist office billing an E/M code with the time codes that are listed above then they are billing incorrectly - the insurance will and should have an CCI edit in place to deny these charges due to bundling rules if these codes are billed together.

 

[Regina]

As I said, depending on the carrier. I have 2 specific carriers that require a medical psychologist to use E/M code with (90833, 90836, 90838 for medication management only and the E/M code with (90832, 90834, 90837) if therapy services where documented during the medication management visit. I have it in writing from the specific carriers. Thank you

 

[TiffanyM]

As I said, depending on the carrier. I have 2 specific carriers that require a medical psychologist to use E/M code with (90833, 90836, 90838 for medication management only and the E/M code with (90832, 90834, 90837) if therapy services where documented during the medication management visit. I have it in writing from the specific carriers. Thank you

Hi Regina,

Thanks for the response - this is very interesting - I recently audited a mental health insurance company and like your stating above they were allowing these services to go through - they were charged for several errors for allowing payments for both codes - which this insurance carrier agreed that their system failed to denied the charges - they had to notify the providers office and request re-bills after there adjustments.

Of course I don't know which carrier you are referring or what type of documentation they could be providing to allow both codes for reimbursement even with E/M documentation. Thanks for the input I will pass this along to my fellow auditors so we can put this on our radar.

Thanks - interesting stuff - please continue to add any additional information if you would like.