CPT Code Changes Coming

Although CPT coding for insurance billing purposes is outside the scope of risk management services provided under PRMS’ professional liability insurance policy, we do know that it’s a hot topic for psychiatry right now. If you’re not aware of the upcoming changes, you need to find out about them before January 1, 2013.

PRMS staff have attended more than two dozen psychiatry meetings since September 1, 2012. All but a few have had at least one session on the program explaining the huge changes ahead. In short, as we understand it, the CPT codes psychiatrists and other behavioral health practitioners have used for many years are being overhauled, and many of the most commonly used codes are being eliminated, with new codes being established.

As one presenter I heard stated, “Even if you don’t submit claims to patients’ insurance companies yourself, your patients will expect you to provide them with properly coded bills so that they can seek reimbursement directly. You need to know the new codes and use them properly.”

If you are a member of the American Psychiatric Association, you may find this site helpful: http://www.psych.org/practice/managing-a-practice/cpt-changes-2013.

Members of AACAP can check this site: http://www.aacap.org/cs/business_of_practice/reimbursement_for_practitioners.

You can also check with the AMA or your state medical society for resources they may have. APA district branches may also be able to help. Of course, there are a number of commercial enterprises that offer training in this area, but since we can’t vouch for the quality of their training, we cannot make recommendations.

Forewarned is forearmed. January 1 will be here before you know it!