Are you a primary care provider struggling with mental health coding? If so, you are not alone. Many healthcare providers find coding for mental health services to be challenging, especially since it is not something they specialize in. Below you will find mental health coding tips designed to make your life a little easier. But first, let’s take a look at CPT (Current Procedural Terminology) codes for mental health.
What are CPT Codes?
CPT codes are used to request payment for services provided and are extremely important when it comes to getting reimbursed from insurance companies. CPT codes were developed by the American Medical Association and are assigned to each and every service that a medical provider may provide a patient, from surgical, to diagnostic, and everything inbetween. Therefore, you want to make sure you are using the right codes.
Mental Health Coding Tip 1: Make sure you are adequately billing for your time with patients. As a provider, you spend a lot of time with patients going over test results, counseling patients and their family members, and more. All of this time spent should be accounted for and billed for.
Mental Health Coding Tip 2: Use appropriate diagnostic codes. When possible, use one of the following primary mental health diagnosis codes:
- 293.83- Mood disorder due to a medical condition
- 296.21, 296.22, 296.30- Major depressive disorder (single episode mild, single episode moderate, and recurrent)
- 296.90- Mood disorder, not otherwise specified
- 300.00- Anxiety disorder, not otherwise specified
- 300.02- Generalized anxiety disorder
- 309- Adjustment disorder with depressed mood
- 311- Depressive disorder, not otherwise specified
- 314, 314.01- Attention Deficit/Hyperactivity disorder
Note that for a depression claim, it is advised to use an Evaluation and Management (E/M) CPT code in combination with the diagnosis codes above. The E/M CPT Codes that should be used include 99201 through 99205, and also 99215.
Mental Health Coding Tip 3: Avoid using psychiatric or psychotherapy CPT codes in a primary care setting. Psychiatric or psychotherapy CPT codes, 90801-90899 tend to be reserved for physicatioc or psychological practitioners only. In order to avoid a denial, it is advised to avoid these codes.
Let AMS Help
At Applied Medical Systems (AMS), we are pros when it comes to medical billing and coding services. If you are a primary care practice that is struggling with denials, let us help. We understand that billing and coding can be complicated. That is why we are devoted to taking the weight off the shoulders of our clients and allowing them to focus their attention back on their patients. To learn more, request a free quote today.