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E&M codes versus therapy CPT codes in mental health billing
Continue reading E&M codes versus therapy CPT codes in mental health billing...
More on Using E&M Codes
An additional possibility for the usage of evaluation and management codes in psychiatry is the consideration of coordination of care and/or medical counseling (not psychotherapy). Psychiatrists who are providing medically complex patient care for clients may find that a significant amount of face-to-face time is spent in providing coordination of care on behalf of the client. If more than 50 percent of your face-to-face time with your client and/or your client’s family is used in coordination of care or medical counseling, you may bill your services using an E&M code based upon the total length of time of the appointment. The face time element is used in outpatient or office settings, while inpatient care includes this consideration in addition to time spent at the patient’s bedside or in the patient’s hospital unit. The Medicare Learning Network (MLN) has a E&M publication for providers called the Evaluation and Management Services Guide, which you can view here.
Page 22 provides further explanation of the coordination of care consideration. The publication also contains the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services, two of three main parts of your E&M resource base.
E&M Codes Revisited
Here at Vālant, we frequently encounter the question, “Can I bill my services using an E&M code?” And here’s the short answer - If you are providing a service to your patient that is a medical evaluation, yes you can. The key to using E&M codes, regardless of your specialty, is documentation of your services. As the insurance industry likes to say, “If it’s not documented, it didn’t happen.” This mantra applies whether you’re considering guidelines from CMS, or private insurers. And so begins the long answer.
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