Psychiatry Coding & Reimbursement Alert

Answer: You are right that, in general, the initial psychodiagnostic evaluation code 90792 (Psychiatric diagnostic evaluation with medical services) cannot be reported with emergency department E/M codes, 99281-99285 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components…). Correct Coding Initiative (CCI) edits bundle these E/M codes into the initial psychodiagnostic evaluation code with the modifier indicator ‘0,’ which informs you that the code bundling cannot be broken down under any circumstances.

 

However, these edits will hold true only if you are reporting both the initial psychiatric evaluation code and ED E/M code for the same provider and for the same patient on the same date of service.

But, as in the case scenario that you have described, the services were provided by different providers, namely, your psychiatrist and the ED physician, so you can report both these services under their individual NPI numbers.