A ARNP sees a patient for a total of 30 minutes. Should there be documentation of history? Exam? Decision making? This should be for at least 30 minutes? Then if therapy is needed 90833? If the ARNP asks questions about how the meds are working and then takes 30 minutes for counseling how should this be coded. I'm unsure if the ARNP is completing the proper documentation to bill a E & M code. Or if she should just bill for therapy. Is it required to use a E & M code because she writes scripts and ask how they are working. I guess I just don't see this happening every week or once a month. Sorry for the confusion I am struggling with coding this correctly.
Hello,
So I think in order to combine somewhat the previous posts, I am going to (hopefully) shine some more light on this:
-What was the intent and purpose of the visit? If the intent was to receive psychotherapy and a prescription was done, then an E/M + 90833 could be appropriate. In my state, only psychiatrists can do this though, and I am not sure which regulations your state have.
-If still yes, then be aware of the time units. If the total time was 30 minutes, this time should have gone towards 90833 and not the E/M; or vice versa. You cannot double dip with time.
-If the patient was in here for management of their behavioral health conditions and the ARNP wrote up a script, then a regular E/M could work instead. The three E/M components (History, Exam and/or MDM) would determine the E/M level, unless Time was properly documented as an overriding factor.
Hope this clears up your confusion instead of adding to it.
If still confused, could you go into more detail of the note itself? I think that's where the main hang up lies with those trying to help.