Unit 7 Discussion- Medicine Guidelines

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1 Medicine Guidelines: CPT Codes 90281 - 99607 Krystina Taylor Medical Coding & Billing, Herzing University MC165-7 – Current Procedural Terminology Coding 1 Jean Andrick October 17, 2023

2 Medicine Guidelines: CPT Codes 90281 - 99607 System: Medicine Title: Psychiatry - Psychotherapy Guidelines: Psychotherapy is the treatment of mental health issues and behavioral problems by a qualified healthcare provider who employs therapeutic communication techniques to alleviate emotional disturbances, modify unhelpful behavior patterns, and promote personal growth and development. The service codes 90832-90838 encompass continuous assessment and adjustment of psychotherapeutic interventions and may involve input from informants during the treatment process. These codes are used for individual patient psychotherapy, and the time indicated relates to face-to-face sessions with the patient, possibly involving informants. The patient must be present for most of the service. If family psychotherapy techniques, focusing on family dynamics, are used, consider using codes 90846 and 90847. However, these codes should not be used for family psychotherapy sessions lasting less than 26 minutes. Codes 90832-90838 can be reported on the same day as codes 90846 and 90847 when the services are distinct and separate. When reporting these codes, select the one that most closely matches the actual duration of the session (e.g., 16-37 minutes for 90832 and 90833, 38-52 minutes for 90834 and 90836, and 53 minutes or more for 90837 and 90838). Do not report psychotherapy for sessions lasting less than 16 minutes. For psychotherapy in crisis situations, use codes 90839 and 90840; these cannot be reported in addition to codes 90832-90838. Code 90785 is an additional code for reporting interactive complexity services when provided alongside the psychotherapy codes 90832-90838. For family psychotherapy, refer to codes 90846 and 90847. The time spent on interactive complexity services should be documented in the psychotherapy service codes or the add-on code for psychotherapy performed with an evaluation and management service. In some cases, psychiatric patients may receive a medical evaluation and management (E/M) service on the same day as psychotherapy. To report both services, they must be distinct and separately identifiable, and specific codes are used to indicate psychotherapy when performed with evaluation and management services (90833, 90836, 90838) as add-ons. The choice of E/M service type and level is based on medical decision-making, and the time spent on E/M activities is not considered when reporting the psychotherapy service. Time should not be the basis for selecting E/M codes, and extended services cannot be reported

3 when psychotherapy with E/M codes (90833, 90836, 90838) is reported. A separate diagnosis is not required when reporting E/M and psychotherapy on the same day. Using the Medicare Physician Fee Schedule (MPFS) look-up tool, here are five CPT codes related to Medicine Guidelines – Psychotherapy and their respective postoperative periods: 1. 90832 – Psychotherapy, 30 minutes with patient – XXX – Free of Global surgical bundling issues 2. 90833 – Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)– ZZZ – Code related to another service and is always included in the global period of the other service 3. 90834 – Psychotherapy, 45 minutes with patient – XXX – Free of Global surgical bundling issues 4. 90836 – Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) – ZZZ – Code related to another service and is always included in the global period of other service. 5. 90838 - Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) – ZZZ – Code related to another service and is always included in the global period of other service. The CPT codes listed above are different type of examples of Medicine Guidelines – Psychotherapy along with their correct postoperative period. Accurately assigning the correct CPT codes for a debridement procedure and grasping the associated postoperative timeframe are crucial for proper billing and reimbursement. References AMERICAN MEDICAL ASSOCIATION. (2022). Cpt Professional 2023 And E/M Companion 2023 Bundle . AMERICAN MEDICAL ASSOCIATE.

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