Coding for mental health issues

August 29, 2018
Renee Dowling
Volume 95, Issue 17

One of the best opportunities to learn about a patient’s mental health is during the annual preventive visit.

Q: How can we get paid for addressing our patients’ mental health issues?

A: While any visit offers an opportunity to discuss the potential for mental health issues, one of the best opportunities to learn about a patient’s mental health is during the annual preventive visit, commonly known as a physical. This visit focuses on the patient individually and is a good time to ask questions regarding mental health, stress, activities of daily living, and sleeping, eating, and work habits.

Below are the codes that should be billed for these visits. They are based on the patient’s age and whether he/she is a new or established patient.

Also, keep in mind: If an illness or abnormality is encountered or a preexisting problem is addressed in the process of performing the preventive medicine service, and if the illness, abnormality, or problem is significant enough to require additional work to perform the key components of a problem-oriented evaluation and management (E/M) service (history, physical examination, medical decision-making), the appropriate office or other outpatient service code (99212–99215) should be reported in addition to the preventive medicine service code. Modifier -25 should be appended to the E/M code to indicate that a significant, separately identifiable E/M service was provided by the same provider on the same day as the preventive medicine service.

Renee Dowling is a billing and coding consultant with VEI Consulting in Indianapolis, Ind. 

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