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I’m a professional fee coder for a behavioral health group. Around 09/01/18, insurances have been denying inpatient 90846 & 90847 as ‘invalid place of service.’ Has anyone else ran into this or does anyone have further information? Any thoughts or advice would be appreciated.
Thanks,
Jay Mominee, CPC, CPB, CPMA, CEMC
If there are siblings that are both patients to the provider. They are both seen the same day and at the same time, same provider, same session. Could 90846/90847 be billed for each sibling? As long as there is separate documentation for each sibling?
Any insight would be greatly appreciated, happy Friday 
A provider sees siblings both patients of this provider at the same time/visit The visit entails the true definition of 90847. The provider provides individual face to face assessments then has the siblings join together to observe behavioral interaction. Can the provider bill 90847 for each sibling? I tried to find something out there in cyber space but could not find a resourceful answer. Any help would be appreciated. Thank you! :confused:
Definition of 90847
The therapist provides 50 minutes (Excludes Service times of less than 26 minutes) of family psychotherapy in a setting where the care provider meets with the patient and the patient’s family jointly. The family is part of the patient evaluation and treatment process. Family dynamics as they relate to the patient’s mental status and behavior are a main focus of the sessions. Attention is also given to the impact the patient’s condition has on the family, with therapy aimed at improving the interaction between the patient and family members. Reviewing records, communicating with other providers, observing and interpreting patterns of behavior and communication between the patient and family members, and decision making regarding treatment, including medication management or any physical exam related to the medication, is included.
90846 Family psychotherapy WITHOUT patient present, 50 minutes
90847 Family psychotherapy (conjoint) WITH patient present, 50 minutes
I mostly see this when the patient is a minor and the mother/father is present during the visit who help provide history, medication or behavioral updates (example: "Mother reports increased irritability), etc. The psychiatrist also lists a review of systems, a mental status exam, history and plan in her notes.
To me, it would seem more appropriate to bill an E&M code rather than 90847 only. Thoughts? I’m getting really frustrated with this as not a lot of insurances will cover 90847/46. When I think of psychotherapy, I was told this is more "talk therapy" where the psychiatrist discusses coping mechanisms etc.
Note: These visits are done in a partial hospitalization setting