Behavioral Health Coding, Billing and Reimbursement Guidelines for 2023 and 2024


Format: On-Demand Webinar
Duration of the training: 60 Minutes
Location: Online Webinar
By: Jamie Taylor, CPB

This webinar will dive into Behavioral Health Coding, Billing and Reimbursement Guidelines for 2023 and 2024.  We will deep dive into strategy for best practices to ensure most accurate documentation and coding, which will lead to appropriate coding and seamless reimbursement. The webinar will be interactive with case examples and hands on exercises. Clinical documentation and coding guidelines will be discussed along with how they affect the selection of the appropriate CPT® and ICD-10 codes. Expert Jamie will discuss how to bill and get paid for behavioral health care services. This webinar highlights how the provision of these services is a valuable use of physician time and effort and will provide broad introduction to behavioral health billing and coding. Physicians are provided with both accurate and actionable information and real-world examples.

Learning Objectives:
  • Identify problems areas of documentation
  • Develop strategy for improvement
  • Learn to select correct CPT and ICD-10 codes
  • Know how to set up practice policies and procedures to avoid audit pitfalls
  • Understand reimbursement strategy and guidelines
Areas Covered in the Session:
  • 2023/2024 Notes
  • Problems Areas of Documentation
    • Documentation does not exist for date of service
    • Lack of medical necessity
      • Documentation should clearly demonstrate the medical necessity of the visit
      • Chief complaint must be clear
      • “Follow up” is not sufficient
      • E/M elements vs E/M code on claim
      • Crisis
      • Interactive Complexity
      • Frequency of visits
      • Tests, Labs and other services
      • No appeal in most cases, can sometimes bill for reduced E/M code
    • Cloned documents
      • Reason for visit
      • Presentation
      • Treatment modality
      • Services provided
      • Barriers
      • Outcomes
      • Homework
      • Be wary of copy and past from one record to another
      • No appeal
    • Time
    • Documentation does not match CPT
    • ICD-10 is not indicated in documentation
    • Missing Documentation Elements
      • Initial Assessments
      • Physician treatment plans should include
      • Therapist Treatment Plans
    • E/M Selection
    • Most recouped service for Psychiatrists
    • CPT code billed is not substantiated
    • Where did the DX come from?
    • Code all DX that effect treatment
    • If the problem/issue no longer exists, do not code
  • Improvement Strategy
  • Selection of CPT and ICD-10 Codes
    • Psychiatric Diagnostic Procedures – 90791, 90792
    • Documentation of Psychotherapy – 90832, 90833, 90834, 90836, 90837, 90839
    • Psychotherapy for Crisis: 90839/90840
    • Interactive Complexity – 90785
    • E/M – New Patient
    • E/M – Established Patient
    • Place of Service  (POS)
    • Medical Necessity
  • Practice Policies and Procedures
  • Practice Policies and Procedures – Patient Experience (CAPHS/HOS)
  • Reimbursement Strategy
  • Final Thoughts
Suggested Attendees:
  • Healthcare Executives
  • Behavioral Health clinicians
  • Office Managers
  • Coders and Billers
  • Audit Staff
  • Quality Staff
  • Physicians
  • Nurses
  • Billing Specialists
  • Providers
  • Claims Adjusters
  • Reimbursement Staff
Presenter Biography:

Jamie Taylor, CPB, has been in the healthcare industry for over 25 years.  Jamie has extensive experience in CMS Government Programs, HEDIS, CAHPS/HOS, Quality, CPT/ICD-10, Documentation improvement, Contract Management, Revenue Cycle Management, Claims, and is published and SME for the AAPC.  Jamie’s has served as the Director of Provider Education and Network Program Manager in her roles within the industry.