Medicare Compliance & Reimbursement - 2017 Issue 4
Reader Question: Learn How to Bill E/M 99212, +90833, and +90863
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Article Overview
This reader Q&A addresses billing relationships among evaluation and management, psychotherapy, and pharmacologic management services under CPT and Correct Coding Initiative guidance. It is aimed at coders, billers, and clinicians who need to understand how payer edits and CPT manual references affect same-day reporting of behavioral health and office visit services.
Why This Topic Matters
The article helps readers evaluate whether certain mental health and office visit services may be reported separately or whether edit logic affects how claims should be assembled. It is relevant for avoiding claim denials and understanding how CPT and CCI guidance interact.
Article Sections
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Question
Introduces a billing scenario involving same-day reporting of office-based and behavioral health services. The question asks whether the services may be billed separately and whether medication management is considered part of the visit.
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Answer
Summarizes the response using payer policy, CCI edit references, and CPT manual guidance. It discusses the relationship among evaluation and management, psychotherapy, and pharmacologic management reporting.
What You Will Learn
- How payer policy can affect whether services are reported together
- How CPT and CCI guidance may intersect for office and psychotherapy-related billing
- Which general service categories are discussed in same-day reporting scenarios
- How add-on and parent-service concepts are presented in behavioral health coding guidance
Who Should Read This
- Medical coders
- Billing staff
- Behavioral health practices
- Physicians and qualified healthcare professionals
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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