Audits and/or Profits? Understanding the 2023 Changes in Coding and Documentation Requirements, an Interactive Workshop-View Recording

Video Transcription

Video Summary

In this presentation, Jeremy Musher and David Yancora discuss the nuances of properly coding and reimbursing psychiatric services, focusing on Evaluation and Management (E&M) codes for inpatient, outpatient, and other settings. Musher, a chair of the American Psychiatric Association (APA) committee, emphasizes understanding medical decision-making as the primary factor in selecting appropriate codes, with time being a secondary consideration. The session delves into examples of how to document various scenarios effectively, ensuring they meet medical necessity and justify the level of complexity.<br /><br />They stress the importance of narrative documentation over checkbox formats for conveying comprehensive patient assessments. Different psychiatric scenarios are examined, using the APA app for audience interaction for code selection, underscoring concepts like accurate complexity levels and risks associated with psychiatry. They also address the nuances of billing E&M plus psychotherapy together, especially focusing on documenting psychotherapy and the E&M component distinctly, despite being part of an integrated service.<br /><br />Yancora provides insights on billing based on time, highlighting the changes that no longer require counseling coordination of care to dominate. They discuss Medicare's guidelines for telehealth services, emphasizing documentation for audio-only services and telepsychiatry's growing role. Upcoming changes and resources for managing these coding challenges are mentioned, with Musher urging practitioners to verify specific payer policies to avoid discrepancies. The session concludes with audience Q&A, clarifying complex billing scenarios involving nurse practitioners, telehealth, and detox situations.

Keywords

psychiatric services

Evaluation and Management

E&M codes

medical decision-making

narrative documentation

APA committee

complexity levels

psychotherapy billing

Medicare guidelines

telehealth services

telepsychiatry

payer policies

billing scenarios

nurse practitioners