Agencies
Services
Provider Notice issued 09/30/02
PSYCHIATRIC CLINIC SERVICES – ASSIGNMENT OF PROCEDURE CODES 00.51 AND 00.53
| To: | Enrolled Hospitals |
| Date: | September 30, 2002 |
| Re: | PSYCHIATRIC CLINIC SERVICES – ASSIGNMENT OF PROCEDURE CODES 00.51 AND 00.53 |
The Centers for Medicare and Medicaid Services (CMS) has notified the Department of the assignment of ICD-9-CM procedure codes 00.51 (implantation of cardiac resynchronization defibrillator, total system (CRT-D)) and 00.53 (implantation or replacement of cardiac resynchronization pacemaker pulse generator only (CRT–P)) effective October 1, 2002. For dates of service prior to October 1, the Department utilized these codes as local codes for psychiatric clinic type A and type B services, respectively.
For dates of service on or after October 1, 2002, hospitals cannot use procedure codes 00.51 and 00.53 to denote psychiatric clinic services. These two codes (with the newly assigned descriptions), will be added to the Ambulatory Procedures Listing (APL) effective for dates of service on or after October 1, 2002.
There will be no other ICD-9-CM codes to replace the procedures currently covered under 00.51 and 00.53 on the UB-92 claim form for psychiatric clinic services. Effective for dates of service on or after October 1, 2002, hospitals must use one of the HCPCS codes shown on the attachment to this notice to specify the appropriate psychiatric clinic service being billed. The HCPCS code must be placed in Form Locator 44 and aligned with the psychiatric service revenue code in Form Locator 42. This is similar to the coding mechanism that hospitals already use to denote emergency department services. Hospitals must still continue to utilize category of service 27 (for type A clinic services) or category of service 28 (for type B clinic services) in form locator 56P to indicate the appropriate psychiatric service being billed.
Rates for the psychiatric clinic services will remain the same. If you have any questions regarding this notice, please contact your UB-92 billing consultant in the Bureau of Comprehensive Health Services at 217-782-5565.
A. George Hovanec, Administrator
Division of Medical Programs
HCPCS CODE FOR PSYCHIATRIC CLINIC TYPE B SERVICES
HCPCS Code |
Description |
90801 |
Psychiatric diagnostic interview examination |
90802 |
Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other mechanisms of communication |
90804 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient |
90805 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services |
90806 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient |
90807 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services |
90808 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient |
90809 |
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient; with medical evaluation and management services |
90810 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient |
90811 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical evaluation and management services |
90812 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient |
90813 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical evaluation and management services |
90814 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient |
90815 |
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of nonverbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient; with medical evaluation and management services |
90845 |
Psychoanalysis |
90846 |
Family psychotherapy (without the patient present) |
90847 |
Family psychotherapy (conjoint psychotherapy) (with patient present) |
90849 |
Multiplefamily group psychotherapy |
90853 |
Group psychotherapy (other than of a multiple-family group) |
90857 |
Interactive group psychotherapy |
90862 |
Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy |
90870 |
Electroconvulsive therapy (includes necessary monitoring); single seizure |
90871 |
Electroconvulsive therapy (includes necessary monitoring); multiple seizures, per day |
90875 |
Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (e.g. , insight oriented, behavior modifying or supportive psychotherapy); approximately 20-30 minutes |
90876 |
Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (e.g. , insight oriented, behavior modifying or supportive psychotherapy); approximately 45-50 minutes |
HCPCS CODE FOR PSYCHIATRIC CLINIC TYPE B SERVICES
S9480 |
Intensive outpatient psychiatric services, per diem |