electroconvulsive therapy coding

1. Identify the procedure, tests, services, etc. from the source document (i.e., medical record, superbill, etc.). Look for any modifying or extenuating circumstances.

2. Identify main terms and subterms.

3. Locate the procedure or service in the Index by checking procedure, anatomic site, synonym, eponym or abbreviated entries.

4. When you have found the entry in the Index, identify the code number next to it and refer to that code section in the main body of the manual. Be sure they match.

5. If a range of codes is given for the procedure, read the description of each entry within the range to make the proper selection that matches or fits as closely as possible to what was actually done.

6. NEVER code directly from the Index! Always verify codes in the main body of the CPT.

7. Ensure you have followed all notes and guidelines at the beginning of the section.

8. If the exact code is not what you are looking for, you may want to use a modifier.

9. If there is not a proper code, you may have to use the unlisted procedure codes in that section. Only use these as a last resort.

CPT Coding Examples

For inexperienced CPT coders to become oriented to the CPT manual, it is recommended to search for procedures with the help of the Index. The Index is printed in the CPT manual in the end pages of the book. The Index is organized by main terms. Each main term can stand alone, or be followed by up to three modifying terms.

The Index is NOT a substitute for the main text of the CPT codebook. Even if only one code appears, the user must refer to the main text to ensure that the code selection is accurate

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Electroconvulsive therapy is good for the medical billers and officers to get the payment on time

Electroconvulsive therapy (includes necessary monitoring). This code is for electroconvulsive therapy (ECT), which involves the application of electric current to the patient’s brain for the purposes of producing a seizure or series of seizures to alleviate mental symptoms. ECT is used primarily for the treatment of depression that does not respond to medication. The code includes the time the physician takes to monitor the patient during the convulsive phase and during the recovery phase. When the psychiatrist also administers the anesthesia for ECT, the anesthesia service should be reported separately, using an anesthesia code. ECT is covered by most insurance plans.

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); 30 minutes. Code 90876 for 45 minutes.

These two procedures incorporate biofeedback and psychotherapy (insight oriented, behavior modifying, or supportive) as combined modalities conducted face-to-face with the patient. They are distinct from biofeedback codes 90901 and 90911, which do not incorporate psychotherapy and do not require face-to-face time. Medicare will not reimburse for either of these codes. 

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Health Care Operations coding

Health Care Operations includes quality improvement activities, credentialing, training, underwriting, compliance services, business planning and development, business management and general administration.

Protected Health Information (“PHI”)

• Identifies a person (reasonable basis to believe that it can be used to identify a person) (e.g.: Name, MR#, address or face photo…)

 

    • Relates to person’s past, present, or future:

 

Physical, Mental Health or Condition; 

 

Provision of Any Treatment or Health Care; or

 

Payment for the Provision of Any Health Care.

 

Prevent PHI from loss, tampering, alteration, destruction, unauthorized access or inadvertent disclosure.

Payment includes bizlling, claims management, medical necessity, utilization review activities, determination of coverage Medical coding training online

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