ACBHCS QA 4.2013 - Alameda County Behavioral Health

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Path 2: Choosing the E/M Code Based on the Elements: Knowing your client try to think ahead of the level of E/M you will be providing. Established Patient Office Visit (Requires 2of 3) CPT Code History Exam MDM 99211 N/A N/A N/A 99212 PF PF Straightforward 99213 EPF EPF LOW 99214 DET DET Moderate 99215 COMP COMP High
Path 2: Choosing the E/M Code Based on the Elements: Knowing your client try to think ahead of the level of E/M you will be providing cont. • 645‐99214: E/M Established Outpatient Moderate Complexity (Requires 2 of 3): • History (detailed) • Exam (detailed) • Medical Decision Making (moderate— must meet 2 Of 3.) ‐ Chief Complaint‐‐required ‐ History of Present Illness (HPI)—4 elements OR 3 chronic conditions. ‐ Past, Family and/or Social History (PFSH)—1 element ‐ Review of Systems (ROS)—2 systems ‐ Number of system/body areas examined—9 bullets ‐ Specific “Bullets” or elements completed within specific systems required for Comprehensive. ‐ Number of Diagnoses or Management Options—3 points ‐ Amount and/or Complexity of Data to be Reviewed—3 points ‐ Risk of Significant Complications, Morbidity, and/or Mortality—Moderate Risk
Page 1 and 2:
ACBHCS QA 4.2013
Page 3 and 4:
AGENDA • Why we are doing this tr
Page 5 and 6: New InSyst Procedure codes map to M
Page 7 and 8: Retained Procedure Codes Old New CP
Page 9 and 10: Psychiatric Diagnostic Evaluation P
Page 11 and 12: Non E/M Codes (Psychotherapy & Cris
Page 13 and 14: Time Spent in Session: examples 1.
Page 15 and 16: PSYCHOTHERAPY FACE TO FACE TIME = 3
Page 17 and 18: Add‐On Codes (+) Add‐On (+) cod
Page 19 and 20: Crisis Code 377‐90839 (Used Alone
Page 21 and 22: Crisis Code 377‐90839 + 378‐908
Page 23 and 24: Add‐On Code for Additional Servic
Page 29 and 30: Interactive Complexity (+) 491‐ 9
Page 31 and 32: Psychotherapy Add‐on Codes to E/M
Page 33 and 34: Evaluation and Management (E/M) Cod
Page 35 and 36: CPT E/M New client Definition—CBO
Page 37 and 38: Two Paths to E/M Selection • PATH
Page 39 and 40: Path 1: Choosing the E/M Code Based
Page 47 and 48: See hand‐outs Progress Note Templ
Page 49 and 50: Medical Necessity—CMS • The Cen
Page 51 and 52: General Principles of Documentation
Page 55: Path 2: Choosing the E/M Code Based
Page 63 and 64: See E/M Progress Note Template Base
Page 65 and 66: Medication Support: RN/LVN/Psych Te
Page 67 and 68: Elimination of AB3632 procedure cod
Page 69 and 70: Training Resources: The National Co
Page 71: Resources continued: • AMA Code B
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ACBHCS QA 4.2013 - Alameda County Behavioral Health

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