The patient receives medical evaluation and management services. These services involve a variety of unique, medical management responsibilities for psychiatric patients, such as:
• medical evaluations
(Eg tests for assessing comorbidity of mental condition, drug interaction and physical examination).
• medication management, when indicated.
• medical orders
• interpretation of laboratories or
• any other diagnostic study and
• observation
This visit must be clearly documented in the file.
90785
Interactive: this concept includes and recognizes the effort required for situations where there is: difficulty of communication for different types of patients and situations that represent important factors that complicate and increase the intensity of the primary psychiatric process.
90791
This service is paid once every three years, if the patient has not had
other services with the provider or another participant of the group during that period of time.
During the initial examination code 90791; the provider conducts an interview with the patient to acquire a complete medical history (including past, family, social) and psychiatric history, mental status, and disposition to obtain a diagnosable disorder. In some cases, the initial diagnostic interview (code 90791) may include: communication with family or other sources, and in certain circumstances, it may also be necessary that other informants will be seen in place of the patient. The extent of mental status evaluation depends on the patient’s condition. There are some symptoms of psychopathology that the provider will study to determine the initial treatment plan, such as, but not limited to, the patient’s appearance.
90792
This service is paid once a year.
The code 90792; in addition to including (such as code 90791) history and mental status of review and review and / or diagnostic study orders as necessary, recommendations (includes communications with family or other sources). It also includes the psychiatric examination (CMS), prescription of medications when appropriate and any order or reading of laboratory tests.
It is paid more than once per patient when an evaluation is carried out separating a different diagnosis with the patient and other informants.
It is not paid on the same day as a psychotherapy, nor on the same day as an evaluation and management (E / M codes)
When reporting the add-on codes, the real time spent in the meeting must be taken into consideration. Example:
– from 16 to 35 minutes the codes to report are 90832-90833
– from 38-52 minutes the codes to report are 90834-90836
– of 53 minutes or more the codes to report are 90837 or 90838 according to
Apply
When an evaluation and management (E / M) is carried out in conjunction with the same-day psychotherapy by the same physician (90833, 90836, 90838), the evaluation and management service (E / M) documentation must identify a significant encounter separate from psychotherapy. Please refer to the assessment and management (E / M) criteria reported in the Evaluation and Management Section of the Triple S-Health Participant Payment Policy Manual. Clear documentation of assessment and management services is recommended in a separate section within the patient’s record as these services are auditable
