9072 billing

[NeuroKlitch]

Started a new attending job. I will be inheriting a large portion of my patients from psychiatrist who left the practice. Would I be billing all of them as 9072 since they are new to me, assuming it wasn't billed in the last year, even tho they are an established patient. Also is 9072 a modifier that is added as a code in addition to the regular e/m codes. Thanks

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[WisNeuro]

Do you mean 90792?

 

[NeuroKlitch]

Yes sorry

 

[NeuroKlitch]

Or can psychotherapy add on be put on in addition to the 90972 can it only be billed alone

 

[hamstergang]

90792 can only be billed alone, not with an E&M code and not with a psychotherapy code. You certainly can use it for patients new to you, but you could also just do normal follow up billing.

 

[NeuroKlitch]

Ok, just wanted to make sure that's normal practice. My first patient is yet to be scheduled . I imagine 90972 would be the best initial way to bill all of them until their first follow up with me from an rvu and simplicity stand point.

 

[splik]

Depends on the insurance, when they last had a 90792 eval and what you are doing in the visit. If it’s a follow up you need to bill as a follow up. If you are performing and documenting a full psych dx eval with pmfsx and they haven’t had a 90792 by a psychiatrist in your group in a year then you are good go to per Medicare guidelines. For commercial insurance it’s usually okay to bill more than once a yr but Medicare says only once a yr outpatient for same specialist or group of same specialists.

Cannot be used with therapy codes and is instead of an E&M code. New pt E&M codes eg 99204/5 can only be used once every 3 yrs per person or group with same specialty. So if a psychiatrist in your group did a new pt visit in the past 3 yrs you couldn’t bill that.