Get more specific with new versions of these standard E/M codes.
When the 2016 CPT® coding books come out, you’ll have a revised set of E/M codes that should make coding for prolonged services that include psychotherapy a lot easier.
“It’s good to see that CPT® is including psychotherapy in the prolonged services code set,” says Suzan (Berman) Hauptman, MPM, CPC, CEMC, CEDC, director of PB Central Coding at Allegheny Health Network in Pittsburgh, Pa.
Read on to check out what the revised codes will look like, and get some expert input on when to use them.
CPT® 2016 will include updates to the following codes (emphasis added to show the revisions):
According to Hauptman, these codes will only help you capture the pay you deserve when you are coding for prolonged services that involve psychotherapy. “This type of care, inherently, requires time — and often more time than was reportable prior to this [code] change,” she says.
“Also further clarifying when to use the code — ‘beyond the typical service time of the primary procedure’ — illustrates that it could be added on to any service level; not just the highest,” Hauptman says.
Advice: As with any revised or new codes, keep your ear to the ground about 99354/99355. Check in chat rooms, and with your local coding community experts, to see who’s using the code and how payers are receiving it.
And, of course, check Medicare transmittals regularly. “We’ll have to see how CMS develops policy around these clarifications,” Hauptman says.