The field of psychiatry is unique, in that each day is different, depending on what patients are seen and what their issues at hand are. Many times, psychiatrists are required to admit patients that are under severe stress or mental anguish and there is simply not time to provide a comprehensive mental status exam. These psychiatric emergencies can be common, so having a process in place that deals with this specific situation is imperative. If this has happened on a regular basis, your process is likely set in stone, but you likely understand the confusion that sometimes happens when it comes to billing for psychiatric emergencies like these. Even though there is a coding exception for unobtainable history, how do you code for patients that do not specifically meet the code criteria?
First of all, there is no disclaimer for the exam portion of the appointment, but the federal documentation guidelines say that if there is some variance allowed. The best option is to look into and consider coding my time counseling, which a lot of psychiatry services resemble. There is also a CPT code that is labeled psychotherapy for crisis, which oftentimes can pay better than some admittance codes. However, this will require that you provide at least 30 minutes of psychotherapy service with the patient. This may not always be the case in a situation where the patient is feeling anxious or stressed. The next option is to code the appointment as a psychiatric diagnostic evaluation, which does not require as much firm documentation criteria as some of the other admitting codes.
Efficiency and details count, especially when it comes to coding and billing for your practice. Medical billing impacts revenue directly and the overall success of the practice is usually tied to billing efficiently with the right codes. Look at standard admit codes in your coding manual and see first if there is an existing code that you can use. If not, consider using one of the above codes to bill for services. If you’ve already looked over these codes and are still having trouble finding a code that fits, talk to our team of professionals. For over 20 years, we have worked to make each client’s medical billing process more efficient and accurate.
If you’ve had problems in psychiatric coding and billing, contact us to learn more about how our medical billing services can give you the tools to solve problems with practical solutions.
Guide: Accountable Care Organizations
Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.