Tuesday, November 13, 2012

The New 2013 CPT Coding Manual : Shame on the American Medical Association!

You've heard it everywhere: the wave of the future for medicine is Electronic Medical Records.  They make for better care, easier communication, fewer errors, easier portability, and everyone loves seeing a doctor who spend their appointment hunched over a screen asking questions to fill in the right check boxes.  Yesterday, as I hit "submit" on a prescription, the computer informed me that it had a problem and logged me out with instructions to sign in and start over.  My hospital is spending $100 million dollars on a new system (how many people could we provide care for for that?), and the federal government has deemed the electronic life so important that it's paying physicians to do this, to the tune of $44k.  

With that as a preview, and with the statement that this is soooo important, let me rant about something else which you are going to hear a lot about from me in the coming weeks.  The way psychiatrists and other mental health clinicians code  health insurance claims is going to change on January 1st.  The codes are called CPT codes, and if your doc submits to insurance, you've never thought twice about this, and if they don't, there's an innocuous number on the statement you get (probably 90804, 90805, 90806, 90807, or 90862 -- up until now it's been pretty easy, there aren't a lot of choices here.   So 7 weeks from now, about.  The new codes are more complicated, in fact they are so complicated that multi-hour courses are being offered, webinars are up, Powerpoints are going on professional society websites.  As the codes change, the requirements for how we document changes, and so far, I don't know of anyone who is exactly sure how to do this.  That's actually not true, I know one gentleman whom I call the CPT-God and he will be helping to train the leaders of the psychiatric society this weekend so that they can teach their members.  What about the half of psychiatrists who aren't in professional societies, or those who can't make the sessions..... I'm predicting some confusion.

Okay, so one thing everyone in the know says, in the change from the current CPT (CPT stands fro Current Procedural Terminology, just so you know), to a heavier reliance on the Evaluation and Management Codes (E/M), it's helpful to read a book to learn this.  If you've gone to a pediatrician, or a primary care doctor, and they hand you a slip to give to their checkout staff and it has a code for level of complexity ranked 1-5, and now psychiatry will be doing this, too.  

Okay, so I need to buy a book, read it, and take a course.  Got it.  Course is scheduled.  
So I go to Amazon and I can buy the paperback for $71.73 or the spiral bound for $92.49.  The e-book, on kindle, where I can access it on my computer and my cell phone (nice in the office), oh they don't have that.  No Kindle/Nook version.  Because who needs that electronic stuff anyway?  I tried Barnes & Noble: Nope, no CPT 2013 there.  You can pre-order how-to manuals for just shy of $400, but I think I will pass on that. 

Finally,  I surfed around and the AMA website does offer an ebook for $109.95 (It costs more?  There are no production costs!  You can get my novels off Amazon to a Kindle app on almost any device for 99 cents, and when Shrink Rap came out and people asked us for the Kindle version, our publisher had it available within days!).  So the $109.95 ebook can apparently download to my iPad or my iTouch.  Nothing about my iPhone (the one gadget I use).

Okay, so I downloaded a free 2012 CPT app which gives me the basics on the E/M codes.  The new psychotherapy codes I am starting to get.  It will all be good, I'm sure, but give it time.

So we're in the electronic age or not?


Joel Hassman, MD said...

If what the office manager tells me is true, the new CPT code for what was 90801 for us as psychiatrists will get us $92 reimbursement for that service by Medicare. Fascinating, isn't it. The more things change, the more they don't stay the same, they regress. This to me is another effort to marginalize and minimize the role of psychiatry. As this garbage plays out and the risks for fraud are made clearly apparent, watch how Medicare will threaten psychiatry with cease and desist orders. From court!

Dinah said...

Joel: See my post on KevinMD today: http://www.kevinmd.com/blog/2012/11/medicare-devalue-work-psychiatrists.html