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,sgchiapricnverxices START HERE PSYCHIATRIC DIAGNOSTIC PROCEDURES 1 With medical services? No Yes 90791 90792 INDIVIDUAL PSYCHOTHERAPY GROUP/FAMILY PSYCHOTHERAPY OTHER PSYCHOTHERAPY 1 Why? 1 Who was there? 2 With E/M services? a Interactive complexity? 3 Visit length? 4 Interactive complexity? vpewn15nbfperxieun,rtceydres vimilarnifnutr(neootrpnptnanqexeln3nifipialn htswipalncaren-/snserxice [,sgchiaprispsnuhtndsenphenvv223nctyenifspeaynton ]V0 V1 nore defplgnefctdfpernwagmefpnwrtolemsn Oecadsentonoaildrenptnctmwlepelgnytcdmefpnphen rexieuntonsgspemsa:n),rtceydrenptyif.n9afyott(n otrn,sgchiaprisps N
Dape Phieonctmwlaifp keoerralnstdrce Dtcdmefpif.nbfperxieus 9isptrgntonwresefpnillfess,aspnwsgchiapricnhisptrg,aspnmeyicalnhisptrg vtcialnafynoamilgnhisptrg Etrmdlapitf/wrt.ftsis Treapmefpnwlaf Cssessmefpntonphen wapiefpgsnaoilipgnptnayheren ptnphenpreapmefpnwlaf SdlpiaIial yia.ftses qe.iolensi.fapdre Ptmwrehefsixenmefpaln spapdsneiamifapitf InteractivewInterviesqwreuhire tfewolgglsinbwagqlwdewmlch:entem Dexices emwltgey The ctfyipitfnfecessipapif.ndsentonifperacpixenyexices Sefpalnvpapdsn-Iamifapitfs yn08dcmc +h(c qexelntonptfscitdsfess Cppefpitfnafyn ctfcefprapitf SttynafynOehaxitr Ptfpefpntonphtd.hp Semtrg bfpe.rapixensefstrgn odfcpitf bfpe.rapixenmtptrn odfcpitf v v p6a3v h h* jriefpapitf ke.isprapitf Cppefpitfnafyncalcdlapitf kecall qaf.da.e Ptfsprdcpitf
Deoifen[bfperacpixenPtmwleIipg: Salayawpixenctmmdficapitf Pare.ixernemtpitfsntrnOehaxitr vefpifelnexefp,lagne diwmefpmnwhgsicalnyexicesmnifperwreperj vpewn25ntherawedpicnverxices A B C INDIVIDUAL PSYCHOTHERAPY GROUP/FAMILY PSYCHOTHERAPY OTHER PSYCHOTHERAPY 1 Why? 1 Who was there? 2 With E/M services? a Interactive complexity? 3 Visit length? 4 Interactive complexity? 8
2C5nbfyixiydaln,sgchtpherawg Treatment (Attempt to alleviate the emotional disturbance, reverse or change maladaptive patterns of behavior, and encourage personality growth and development) 1 Why? Crisis (Urgent assessment and history of a crisis state, a mental status exam, and a disposition to defuse the crisis and restore safety) 2 E/M Services too? Yes No 3 Visit length? 3 Visit length? E/M + 90833 E/M + 90836 30 minutes 45 minutes 90832 90834 Less than 30 minutes 90832 or E/M + 90833 E/M + 90838 60 minutes 90837 60 minutes 90832 E/M + 90838 + Prolonged Service >60 minutes 90837 + Prolonged Service Each additional 30 minutes 90834 4 Interactive complexity? Yes + 90785 No No additional codes needed Psychotherapy for crisis codes assume a level of interactive complexity. Therefore, the interactive complexity code (+ 90875) may not be reported in addition to these services. Dtcdmefpif.nbfyixiydaln,sgchtpherawg Dape TimenswefpnotrnphenefctdfpernoaceWptWoace Tgwentonpherawedpicnifperxefpitf Tar.epnsgmwptms,rt.ressnptuarynachiexemefpntonpreapmefpn.tals -/SnserxicesnwrtxiyeyMnionserxicenwrtxiyeynisn wsgchtpherawgnuiphn-/s Dia.ftses qe.iolensi.fapdre +dspioicapitfntonpimenswefpnotrnserxicesnltf.ernphafnn0n mifdpes InteractivewInterviesqwreuhire tfewolgglsinbwagqlwdewmlch:entem Dexices emwltgey The ctfyipitfnfecessipapif.ndsentonifperacpixenyexices V
2*5nFrtdwn/nEamilgn,sgchtpherawg 1 WHO WAS THERE? Family without the Patient 90846 Family with the Patient 90847 Multiple Families (including Patients) 90849 A Group of Patients (other than multiple-family) a INTERACTIVE? No Yes 90853 90853 + 90785 Dtcdmefpif.nFrtdwn/nEamilgn,sgchtpherawg Dape EaceWptWoacenefctdfpernpime Tgwentonpherawedpicnifperxefpitf Tar.epnsgmwptms,rt.ressnptuarynachiexemefpntonpreapmefpn.tals -/SnserxicesnwrtxiyeyMnionserxicenwrtxiyeynisnwsgchtpherawgn uiphn-/s Dia.ftses qe.iolensi.fapdre EtrnEamilgn,sgchtpherawgMnphenotlltuif.nshtdlynalstnOenifcldyey5 qispntonphtsenwresefpnydrif.nphensessitf EtrnFrtdwn,sgchtpherawgMnphenotlltuif.nshtdlynalstnOenifcldyey5 7dmOerntonwerstfsnifnphen.rtdw 10
2P5nnjphern,sgchiapricnverxices V0846 V08N6 V08 0 V0880 V0882 V0886 V088 V088V,sgchtafalgsis 7arctsgfphesis -lecprtctfxdlsixenpherawg 9gwftpherawg -fxirtfmefpalnmafiwdlapitf,sgchtlt.icalnexaldapitfntonrectrys Ptfsdlpapitfnuiphnoamilg,rewarapitfntonrewtrp 2P5nnjphern,sgchiapricnverxices V08N nb V08NVnnTherawedpicnrewepipixen prafscrafial ma.fepicnspimdlapitfn)tsv n preapmefp V08 6nB V08 Nnnbfyixiydalnwsgchtwhgsitlt.ical pherawgnifctrwtrapif.noitoeeyoac(npraifif.nogn afgnmtyalipgn)oacewptwoacenuiphnphenwapiefp Mn uiphnwsgchtpherawg 11
-Ipra5nn,harmactlt.icnSafa.emefp TutnPtyes YV08N3nW,harmactlt.icnmafa.emefpMnifcldyif.n wrescriwpitfnafynrexieuntonmeyicapitfmnuhefn werotrmeynuiphnwsgchtpherawgnserxices j7qunejkn&v-n*unpqb7bpcqn,vup9jqjfbvtvn),hdmn,sgd nb7nvtct-vn 9-k-nT9-Un9CR-n,k-vPkb,TbR-n C&T9jkbTU S00N4nB *rieontooicenxisipnotrnphenstlenwdrwtsenton mtfiptrif.ntrnchaf.if.nyrd.nwrescriwpitfsndseynifnphen preapmefpntonmefpalnwsgchtfedrtpicnafynwerstfalipgn yistryers Dtcdmefpif.n,harmactlt.icn Safa.emefp 4 Dape EaceWptWoacenefctdfpern pime bfperxalnhisptrg Dia.ftses Sefpalnspapdsn eiamifapitfnresdlpsmnuiphn emwhasisntfnreswtfsenptn meyicapitf kexieuntonsiyeneooecps bfotrmapitfntfnphen meyicapitfnwrescrioeymnion anwrescriwpitfnisnwrtxiyey qe.iolensi.fapdre v Dape EaceWptWoacenefctdfpern pime Dia.ftses 7amentonmeyicapitfn Oeif.nchec(ey keastfsnotrnctfpifdapitfn trnchaf.esnifnmeyicapitf qe.iolensi.fapdre 12
Pefpraln7erxtdsnvgspemn Cssessmefpsn/nTesps P7vnCssessmefpsn/nTesps,sgchtlt.icalnTespif.n)VN101nB VN103 7edrtwsgchtlt.icalnTespif.n)VN118nB VN120 7edrtOehaxitralnvpapdsn-Iamn)VN11N DexeltwmefpalnTespif.n)VN110nB VN111 jphernp7vncssessmefpsn/ntespsn)vn106nqn VN126 13
,sgchtlt.icalntespif. Seyicallgnaccewpeynpespsnotrnexaldapitfnton ifpellecpdalnspref.phsmnwsgchtwaphtlt.gmn wsgchtygfamicsmnmefpalnhealphnris(smnifsi.hpmn mtpixapitfmnafyntphernoacptrsnifoldefcif.n preapmefpnafynwrt.ftsis 7tpnwsgchtpherawedpicnmtyalipiesMnOdpnaren yia.ftspicnaiysa Dtcdmefpif.n,sgchtlt.icalnTespif. Dape TtpalnpimeMnifcldyif.5 EaceWptWoacenpimenaymifisperif.npespsnptnphenwapiefp bfperwrepapitfntonphenpespnresdlps,rewarif.nphenrewtrpmnifcldyif.nifpe.rapitfntontphernyapanac direy,apiefpna.e keoerralnstdrce keastfnotrnuhichnwsgchtlt.icalnpespif.nisnuarrafpey,rtceydresndseyn)charpnrexieumnifperxieumnepc 9isptrgnton,resefpnbllfess kelexafpnseyicaln9isptrg Sefpalnvpapdsn-Iamifapitfn/n&wyape kesdlpsn/neifyif.sn/n,rt.ress Dia.ftses,lafntoncare qe.iolensi.fapdre 14
7edrtwsgchtlt.icalnTespif. Tespif.nifpefyeynptnyia.ftsenafyncharacperiLen phenfedrtct.fipixe eooecpsntonmeyicaln yistryersnphapnimwif.enyirecplgntrnifyirecplgntfn phenoraifa Dtcdmefpif.n7edrtwsgchtlt.icaln Tespif. Dape TtpalnpimeMnifcldyif.5 EaceWptWoacenpimenaymifisperif.npespsnptnphenwapiefp bfperwrepapitfntonphenpespnresdlps,rewarif.nphenrewtrpmnifcldyif.nifpe.rapitfntontphernyapanac direy,apiefpna.e keoerralnstdrce keastfnotrnuhichnwsgchtlt.icalnpespif.nisnuarrafpey,rtceydresndseyn)charpnrexieumnifperxieumnepc 9isptrgnton,resefpnbllfess kelexafpnseyicaln9isptrg Sefpalnvpapdsn-Iamifapitfn/n&wyape kesdlpsn/neifyif.sn/n,rt.ress Dia.ftses,lafntoncare qe.iolensi.fapdre 16
7edrtOehaxitralnvpapdsn-Iam bfpefyeynptnyescrioenphenwrtcessnton.apherif.n clificalnifotrmapitfnphapnisndseynptnassessnoraifn ygsodfcpitfnafynphenwrt.ressitfnafynchaf.en ifnsgmwptmsntxernpimea Dtcdmefpif.n7edrtOehaxitr vpapdsn -Iams Dape Plificalnassessmefpnto5 Thif(if. keastfif. +dy.mefp TtpalnpimeMnifcldyif.5 EaceWptWoacenpimenaymifisperif.npespsnptnphenwapiefp bfperwrepapitfntonphenpespnresdlps,rewarif.nphenrewtrp,rtceydresndseyn)charpnrexieumnifperxieumnepc 9isptrgnton,resefpnbllfess Sefpalnvpapdsn-Iamifapitfn/n&wyape kesdlpsn/neifyif.sn/n,rt.ress Dia.ftses,lafntoncare qe.iolenvi.fapdre 1N
DexeltwmefpalnTespif. VN1105nvcreefif.npttlnptniyefpiognchilyrefnuhtn shtdlynreceixenanmtrenifpefsenyia.ftspicnexaldapitfn trnassessmefpan &sdallgnwerotrmeynognweyiapriciafs VN1115nbfpefsixenyia.ftspicnexaldapitfntrnassessmefpn phapnifcldyesnafnassessmefpntonmtptrmnlaf.da.emn stcialmnayawpixenafy/trnct.fipixenodfcpitfif.nogn spafyaryileynyexeltwmefpalnifsprdmefps e.mn*agleg vcalesntonbfoafpndexeltwmefpn Dtcdmefpif.nDexeltwmefpalnTespif. Dape TtpalnpimeMnifcldyif.5 EaceWptWoacenpimenaymifisperif.npespsnptnphenwapiefp bfperwrepapitfntonphenpespnresdlpsn)uhefnawwrtwriape,rewarif.nphenrewtrpn)uhefnawwrtwriape Tespsn,erotrmey kesdlpsn/neifyif.sn/n,rt.ress Dia.ftses,lafntoncare qe.iolenvi.fapdre 1
jphernp7vncssessmefpsn/ntesps VN1065nCssessmefpntonawhasia ifcldyesnassessmefpntoneiwressixenafynrecewpixensweechn afynlaf.da.enodfcpitfmnlaf.da.enctmwrehefsitfmnsweechn wrtydcpitfnaoilipgmnreayif.mnswellif.mnuripif. e.mnogn*tsptfndia.ftspicncwhasian-iamifapitf VN1265nvpafyaryiLeynct.fipixenwerotrmafcenpespif. -Iamwle5nThisnpespif.nmi.hpnOenwerotrmeyntfnanwapiefpn uhtnhasnsdooereynanoraifnifzdrgnptnyepermifenafgn ctmwrtmiseynodfcpitfif.a Dtcdmefpif.njphernP7vn Cssessmefpsn/nTesps Dape TtpalnpimeMnifcldyif.5 EaceWptWoacenpimenaymifisperif.npespsnptnphenwapiefp bfperwrepapitfntonphenpespnresdlpsn)uhefnawwrtwriape,rewarif.nphenrewtrpn)uhefnawwrtwriape,rtceydresndsey 9isptrgnton,resefpnbllfess Sefpalnvpapdsn-Iamifapitfn/n&wyape kesdlpsn/neifyif.sn/n,rt.ress Dia.ftses,lafntoncare qe.iolenvi.fapdre 18
9ealphnafyn*ehaxitrn Cssessmefpsn/nTesps 9ealphnafyn*ehaxitrnPtyes 1V
CssessmefpntrnkeWassessmefp &seynptniyefpiognphenwsgchtlt.icalmnoehaxitralmn emtpitfalmnct.fipixemnafynstcialnoacptrsn imwtrpafpnptnphenwrexefpitfmnpreapmefpmntrn mafa.emefpntonwhgsicalnhealphnwrtolemsa Dtcdmefpif.nCssessmefps Dape -xaldapitfnmephtysndsey joserxapitfs kesdlpsntonwsgchtwhgsitlt.ical mtfiptrif. vdmmargntonphenassessmefp kectmmefyapitfs 7dmOernton16Wmifdpendfips Ttpalnpimenswefpnuiphnphenwapiefp Dia.ftsis 20
bfperxefpitfn,rtceydres Dtcdmefpif.nbfperxefpitfs Dape bfperxefpitfnmephtysndsey joserxapitfs kesdlpsntonwsgchtwhgsitlt.ical mtfiptrif. vdmmargntonphenifperxefpitf kectmmefyapitfs 7dmOernton16Wmifdpendfips Ttpalnpimenswefpnuiphnphenwapiefpntrnoamilg Dia.ftsis 21
-xaldapitfnafynsafa.emefpn verxices -/Snverxices PafftpnOendseynOgnTiern3ntrnTiern4nwrtxiyers Stspnctmmtfndsenifnmefpalnhealphnisnotrn ifwapiefpnxisips &seynotrnhealphnafynoehaxitrnassessmefpn afy/trnifperxefpitfnserxicesnwerotrmeynognan whgsiciafmnclificalnfdrsenswecialispn)p7v Mntrn fdrsenwracpipitfern)7, 22
Styioiers Styioiers -/SnStyioiersnmagnOenfeeyeynyewefyif.ntfnphenctyesn phapnarenoilleya 225nbfcreaseynwrtceydralnserxice 265nvi.fioicafpMnvewarapelgnbyefpioiaOlen-/SnverxicenOgnphen vamen,hgsiciafntfnphenvamendagntonphen,rtceydrentrn jphernverxice FP5nverxicenhasnOeefnwerotrmeynifnwarpnOgnanresiyefpn dfyernphenyirecpitfntonanpeachif.nwhgsiciaf F-5nThisnserxicenhasnOeefnwerotrmeynOgnanresiyefpn uiphtdpnphenwresefcentonanpeachif.nwhgsiciafndfyernphen wrimargncareneicewpitf 23
Styioiersn)ctfpA C95nverxicesnwrtxiyeynOgnanclificalnwsgchtlt.isp C+5nverxicesnwrtxiyeynOgnanclificalnstcialnutr(er 9-nifnctfzdfcpitfnuiphnvC5nverxicesnwrtxiyeynOgnanfdrsen wracpipitferntrnclificalnfdrsenswecialisp 9-5nverxicesnwrtxiyeynOgnafgntphernmiyWlexelnwracpipitfer Cyxafceynwracpicenfdrsen)k7nuiphnmaspersnifnfdrsif.nafynmaztrnifn wsgchiapricntrnmefpalnhealphnfdrsif.nortmnaccreyipeynschttl qicefseynmarria.enafynoamilgnpherawisp qicefseynmefpalnhealphnctdfseltr Cnwerstfnhtlyif.nanmasperGsnye.reenifnstcialnutr(Mnmaripalnafynoamilgn pherawgmntrnmefpalnhealphnctdfselif. 9 5nSeyicaiynkehaOilipapitfnjwpitfn)Skj nserxices vc5n7,/p7vnrefyerif.nserxicenifnctllaotrapitfnuiphnanwhgsiciaf NOT:odi fersrsandmydctedbu d c dcsss dasr ans St Dia.ftsisnPtyif. 24
Sefpaln9ealphnDia.ftsisnifn Seyicalnjooices *enauarenphapnion,rimargnparen,rtxiyersn)ftfw,sgchiaprisps narenpreapif.n[mefpalnhealph:n wapiefpsnifnpheirntooicesnphegmnmtspnli(elgmnuilln ftpnoenreimodrseynotrnpheirnserxicesa baeancd9dmnyewressitfmnafiiepgmnepca jwpitfsnotrndtcdmefpif.ndia.ftsis SdlpiaIial CnmdlpiaIial sgspemnifxtlxesnafnassessmefpntfn sexeralnaiesmneachntonuhichnreoersnptnanyiooerefpn ytmaifntonifotrmapitfnphapnmagnhelwnphenclificiafn wlafnpreapmefpnafynwreyicpntdpctmen 7tfaIial Dia.ftsisnarenytcdmefpeynifnanftfaIial otrmapn )wrifciwalnyia.ftsisnphefnayyipitfalnyia.ftsesmnepc 26
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CIisnb &seynotrnrewtrpif.nallnphenxaritdsnyistryersntrn ctfyipitfsnifnphenplassioicapitfn)dvs neicewpnotr5,erstfalipgndistryers Sefpalnkeparyapitf FeferalnSeyicapitfnPtfyipitfs -Iamwles5 Distryers5nSttyMnafIiepgMnstmaptotrmMnsdOspafceWrelapeyMn wsgchtpicmneapif.mnsleewmnimwdlsenctfprtlmnayzdspmefpmnepc &seynotrnrewtrpif.5 CIisnbb,erstfalipgnDistryers,araftiy 7arcissispic vchiltiy Cxtiyafp vchiltpgwal Dewefyefp Cfpistcial josessixewptmwdlsixe *tryerlife 7tpnjpheruisenvwecioiey 9ispritfic Sefpalnkeparyapitf 28
&seynotrnrewtrpif.5 CIisnbbb FeferalnSeyicalnPtfyipitfsnphapnarenpf St rcll d aslsvct ptnphendfyerspafyif.ntrnmafa.emefpnton phenifyixiydalgsnmefpalnyistryera CIisnbR &seynotrnrewtrpif.5,sgchtstcialnafynefxirtfmefpalnwrtolemsnphapnmagnaooecpn phenyia.ftsismnpreapmefpmnafynwrt.ftsisntonmefpaln yistryersa bfcldyes5,rtolemsnuiphnwrimargnsdwwtrpn.rtdw,rtolemsnrelapeynptnphenstcialnefxirtfmefp -ydcapitfalnwrtolems jccdwapitfalnwrtolems 9tdsif.nwrtOlems -ctftmicnwrtolems,rtolemsnuiphnaccessnptnhealphncarenserxices,rtolemsnrelapeynptnifperacpitfnuiphnphenle.alnsgspemn/ncrime jphernwsgchtstcialnafynefxirtfmefpalnwrtolems 2V
&seynotrnrewtrpif.5 CIisnR ThenclificiafGsnzdy.mefpntonphenifyixiydalGsntxeralln lexelntonodfcpitfif.a DvSWRnxsAnbPDWVWPS DvSWR5nDia.ftspicnafynvpapispicalnSafdalnton SefpalnDistryersMnEiophn-yipitf ThenDvSnisndseynotrnyia.ftspicnctyif.A -achndvsnyescriwpitfnhasnanctrreswtfyif.n bpdwvwpsnctye bpdwvwpsnisndwyapeynmtrenore defplgmn phereotremnstmenbpdwvwpsnctyesnlispeynifnphen DvSnmagnOenifctrrecp 30
,rifciwalndia.ftsisn/n keastfnotrnrisip vamenctfcewpnasnifnmeyicalnyia.ftsisnctyif. Deoifeynasnphenmaifnotcdsntonappefpitfntrn preapmefpnydrif.nafnefctdfpera vhtdlynoenlispeynoirspnifnphenytcdmefpapitfn afyntfnphenclaima CwwliesnptnOtphnmdlpiaIial afynftfaiial otrmappif.a,rtxisitfalndia.ftsis ThisnisnanpermnphapnmagnOendseynifnphen ytcdmefpapitfnuhefnpherenisnansprtf.n wresdmwpitfnphapnphenodllncriperianuillndlpimapelgn OenmepnotrnanyistryerMnOdpnftpneftd.hn ifotrmapitfnisnaxailaolenptnma(enanoirmnyia.ftsisa vimilarnptn[li(elg:mn[sdswecpey:mn[wtssiole:n ctfyipitfsa vhtdlynftpnoenctyeymnifspeaynphensi.fs/sgmwptmsn shtdlynoenctyeya 31
bpdw10wps 7eunFdiyelifes,aifnyistryersnrelapeynptnwsgchtlt.icalnoacptrs SefpalnafynOehaxitralnyistryersnydenptn wsgchtacpixensdospafcendse bfnremissitf,sgchtacpixensdospafcendsemnaodsemnafyn yewefyefpnhierarchg,sgchtacpixensdospafcendse 32
Ptmwlicapitfs iffif.nphenfame bmwlemefpnpraifif.nafynwracpice Depermifenphenwtsipitfneachnwlagernmagnoill Depermifenphenoielyntonwlag &pililenytcdmefpapitfnptnyepermifenphen e diwmefp,dpnipnallnpt.ephernctrrecplg 33
kestdrcesn&pililey 2014nP,THn,rtoessitfaln-yipitf 2014nbPDWVWPS 2014nbPDW10WPS 2014n9P,Pv DvSWRnH,rtceydrenPtyif.n9afyOtt(notrn,sgchiaprispsMn Etdrphn-yipitf ThenSefpalnvpapdsn-Iamn-IwlaifeyMnvectfyn -yipitf?despitfsx PhafyranvpewhefstfMn P,PMnP,PW9MnP,PjMnP,SCMnPPvMnP,PWbMnPC7,PMn P-SPMnPE,PMnPFvPMnPbSPMnPjvP 34