tci Outpatient Facility Coding Alert - 2016 Issue 2

You Be the Coder: Know The Difference Between 90791 and 90792

Question: What is the difference between 90791 and 90792? Does 90792 reimburse at a higher rate? How often can you use either code? Can we use 90792 and then 90791, or do we have to wait a certain time frame? New Jersey Subscriber Answer: When the provider performs a diagnostic evaluation that includes collecting information about present and past behavior concerns as well as past family, medical, and social history, you report 90791 (Psychiatric diagnostic evaluation). This also includes diagnostic tests to work up the diagnoses. This code applies to new patients or to patients undergoing re–evaluation. The...

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