Erroneous Application of Payment Cutback to Pharmacologic Management

Why This Topic Matters

The topic matters because incorrect application of a mental health payment limitation can change reimbursement and affect compliance for services reported with specific diagnosis groupings and evaluation and management services.

Article Sections

1. Payment limitation guidance for pharmacologic management

   Overview of the Medicare payment issue, the CMS policy context, and the carrier-level concern addressed in the article.

2. Related diagnosis groupings under ICD-9-CM

   Broad discussion of diagnosis categories associated with the issue, including neuropsychiatric and cognitive disorder groupings referenced by the article.

3. Established patient evaluation and management services

   Discussion of how established patient office/outpatient E/M services are addressed in relation to the same payment limitation topic.