The Current Procedure Terminology (CPT) code set is used to denote the medical and surgical procedures and diagnostic services rendered by clinicians under HIPAA. The key to appropriate insurance reimbursement lies in accurate procedure coding. Coding errors can lead to delayed payments or rejections of submitted claims. Always verify CPT information with the AMA's current CPT manual, which is the ultimate authority on procedure coding.
Procedure Coding Resources for APA Members
Changes to 2023 E/M Billing and Documentation Rules
Beginning January 1, 2023, the current billing and documentation rules for Outpatient E/M services will be extended to include E/M services in other settings (i.e., inpatient, consults, nursing facility, home/residence). Note: the code selection rules and documentation for outpatient services (99202-99215) have not changed.
To learn more about coding and documentation of all E/M services view the APA webinar from December 8, 2022. Link includes access to slides and a revised E/M medical decision making table.
Emerging Topics Series: Evaluation, Management, Coding, and Documentation – What All Psychiatrists in Clinical Practice Need to Know
- Recorded Thursday, December 8, 2022
- 1.5 AMA PRA Category 1 Credits™ **
- Jeremy Musher, M.D., and Sarah Parsons, D.O.
View Recording (with slides and handout) Here
Practical Information on E/M Coding from Psychiatric News
- Guidance to Help Ensure You Are Coding Visits Correctly
- Expert Explains Updated CPT Codes, How to Estimate E/M, Therapy Time
Webinar on the 2021 Billing and Documentation Changes to Outpatient E/M Services (99202-99215)
- Recorded Webinar: Update on 2021 Changes to Billing and Documentation for Outpatient E/M Services
- Webinar Slides
- Quick Guide to the 2021 Update to Billing and Documentation for Outpatient E/M Services
Codes to Know
- Treatment of Smoking Cessation During Outpatient Psychiatric Visits – The guide provides psychiatrists with billing options using add-on codes and additional CPT codes when providing treatment for smoking cessation.
- Interprofessional Telephone/Internet/Electronic Health Record Consultation Codes – The billing guide and patient pamphlet provide guidance to psychiatrists and their patients on the use of the non-face-to-face consultation codes ("curbside consults"). Introduced in 2019, Medicare began paying for these in 2020. The codes are to be used when the patient's treating physician requests an opinion and/or treatment advice from a specialist.
- Online Digital Evaluation and Management Services Codes and Instructions – Instructions and details about three new codes for providing online E/M services to established patients who have not been seen in the past seven days for an E/M visit, and will not be seen in the next seven days for an in-person visit.
- Interactive Complexity Guide – Interactive complexity refers to 4 specific communication factors during a visit that complicate delivery of the primary psychiatric procedure. Report with CPT add-on code 90785.