Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Thursday, December 06, 2012
Tutorials: CPT Coding for Outpatient Psychiatrists for 2013
The way mental health clinicians code their services for insurers is changing on January 1st. A minor thing, a really boring & tedious thing, but I decided I'd learn about it to write about it (oh, I have, but instead of writing, I call it Ranting) and make YouTube how-to videos on how to do the new coding.
Only the new coding takes something that was simple and self-explanatory and makes it really complicated -- it requires courses, manuals with more layers of charts and graphs and algorithms then you want to imagine, and it's all done in a way that has nothing to do with how psychiatry is actually practiced (it's about asking questions to get enough bullet points on your template). I'm seriously considering resigning from the APA over this-- they wanted and supported these changes that make something so simple into a pain, and could potentially be yet one more distraction from taking good care of patients. There are now 21 ways to code a psychotherapy session. However, if you want to learn about the new coding, I'm pleased to report that after hours of technologic hell involving PowerPoint, iPhoto, GarageBand, and iMovie, I now have 4 videos on YouTube about CPT codes for psychiatrists. Thanks to Clink for emailing me a brief how-to list, but in the end I did it all by myself!
It's not looking like the insurance companies have changed their coding for next month, and many people don't know how to do the new coding, so if you're a patient waiting reimbursement, you might want to make sure your therapist/shrink knows to code the new codes (which might not work) and you might want to stay on top of the insurance company. And if you're a mental health professional who gets reimbursed by insurance, you may want to make other plans for that mortgage.
I will tell you that Roy is all in favor of the changes and thinks it's going to lead to much better reimbursements for psychiatry now that we'll be billing like the real docs do.
If you watch these, coffee first. They are really boring. And I think they are only of interest to psychiatrists.
Please do write in the comment section if you find other errors, I will correct them.
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I had a comment I was gonna post but I think it's opening up at least one big can o'worms so I think not.
I'm having enough of a hard time being able to stand myself, my behaviors, failures etc. lately so I don't wanna get piled on.
Hrm, I sound really whiny (like I say, I'm having a hard time standing mysel lately, but it's hard to fight everythingand improve when a ton of curve balls are hitting you and knocking you over. I am trying though).
I hope the CPT thing gets sorted fast cause it sounds like it could impact people just awfully.
Just remember folks, the AMA was supportive of PPACA as well, and how is that panning out these days?
And DSM 5, well, that is such a wonderful advancement of the field as well, just you wait. Oh, and for the edition being published for PCPs and other non psychiatric providers to use? Really will advance psychiatric providers, yeah, right!
Hey colleagues, if you can't see the writing on the wall, let me read it for you:
GET A REAL JOB, YOU ARE SUPERFLUOUS!
Sorry if this insults the authors of this blog, but, to anyone who is a psychiatrist and still belongs to the APA, WHY!? If this is representation, how many stab wounds in your back do you tolerate!?!?
You read it here first, if not already figured it out for yourself, private practice psychiatry is basically dead by 2016 unless you are working such a niche field, no one else can do it and you have a patient population that can sustain you. Congrats if this is true.
If you are me, maybe working in a bar may have a realistic expectation by that time frame!!!
Cynical, nah, that is too optimistic a term!
I've been following along with you this week. I think there may be an error in the final tutorial for add-on timed psychotherapy codes, which are given as 90822 (30 minute) and 90866 (45 minute). I believe they should be 90833 and 90836. The 90838 for 60 minute is accurate.
Anon, It looks like you are right. Not sure where I got those codes from, but I will edit and add a correction, probably not for a few days to the Youtubes. Thank you!
For anyone still struggling with these, I created a free web-based interactive training tool that will let you watch your code being built as you tick off data elements, see a "map" of how the code is built, and optimize your coding and documentation. I won't post the direct link so as not to appear to be spamming, but you can find it by under "Psychiatric Code Coach" on any search engine.
There are also lots of links to resources on the Maine Association of Psychiatric Physicians site (an APA DB, but 99% of the content is public), under the resources tab.
M Price MD
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