Billing for psychiatric evaluations: options for coding and reimbursement.
The complexity of the current practice environment challenges clinicians to master complicated billing and coding regulations. Failure to properly bill and code can result in reduced potential revenue for services providers and, if improperly done, could lead to paybacks or penalties for the clinician. The purpose of this article is to assist psychiatrists in choosing the optimal coding for new evaluations and to understand the documentation requirements. Comparisons are provided between the "psychiatry codes" and the "evaluation and management" series. Details of required history, examination, and medical decision-making are listed in order to provide the tailed knowledge necessary to appropriately utilize some higher paying evaluation and management coding options for psychiatric evaluations.
Goldberg
Richard J
RJ
Department of Psychiatry, Brown University and Rhode Island Hospital and The Miriam Hospital, 593 Eddy Street, Providence, RI 02903, USA. rjgoldberg@lifespan.org
D003657:Decision Making; D004282:Documentation / Q000379:methods / Q000592:standards; D005568:Forms and Records Control / Q000145:classification*; D006801:Humans; D007344:Insurance Claim Reporting / Q000145:classification*; D007358:Insurance, Psychiatric; D006278:Medicare / Q000191:economics; D001523:Mental Disorders / Q000145:classification* / Q000191:economics*; D008605:Mental Health Services / Q000145:classification / Q000191:economics*; D011570:Psychiatry / Q000191:economics*; D014481:United States