Throughout the remainder of the calendar month, the BHCM reassesses the patient’s condition, monitors the care plan, collaborates with the psychiatrist weekly and communicates/consults with Dr. A registry of patients receiving PCCM services also is updated throughout the month. Because this is the initial month of PCCM services what is reported and by whom? Mike for PCCM services in this calendar month and linked to diagnoses for moderate major depression (F32.1) and social anxiety disorder (F40.10).Use of validated rating scales in the assessment and re-assessments during provision of PCCM services is not separately reported, but the time spent in assessment and/or re-assessment is included in the time of PCCM service.The patient requires 60% supplemental oxygen to maintain oxygen saturation greater than 92%.Aggressive management of heart failure is instituted, and administration of diuretics achieves some symptom relief but is complicated by increased creatinine.If the patient or his or her representatives elects to complete advance directive forms, they may do so at any other time with assistance from individuals other than the clinician.Medicare advises clinicians to consult their Part B Medicare Administrative Contractor (MAC) for its documentation requirements, but the agency suggests including (in addition to time spent and the voluntary nature of the services) an account of the discussion, an indication that advance directives were explained, and who was present.These include: PCCM codes ●99492 Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of BHCM activities, in consultation with a psychiatric consultant, and directed by the treating physician or other QHP, with the following required elements: ●99493 Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of BHCM activities, in consultation with a psychiatric consultant, and directed by the treating physician or other QHP, with the following required elements: ● 99494 Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of BHCM activities, in consultation with a psychiatric consultant, and directed by the treating physician or other QHP (List separately in addition to code for primary procedure) (Use 99494 in conjunction with 99492, 99493) Example of PCCM A 17-year-old patient is seen for follow-up of previously diagnosed major depression for which she and her parents refused medication.The patient has been seeking counseling from her school counselor, but a structured depression screening instrument score indicates no improvement in her depression. Mike discusses with the patient and her parents a new service offered in his practice.
The same day, the BHCM assesses the patient’s general emotional and behavioral health using a standardized instrument and advises the patient that she will call in two days with a proposed treatment plan. The BHCM then discusses the patient’s history and assessment with the consulting psychiatrist as part of her weekly collaboration session.t is common for hospitalists to have advance care planning discussions and address advance directives with patients (and families) during an admission for a serious life-threatening condition or end-stage chronic disease. 1, 2016, Medicare began paying for advance care planning services to encourage such conversations and compensate clinicians for the time spent having them.Advance care planning involves discussion of advance directives with the patient, family members, or surrogates.PCCM codes 99492-99494 are reported only by the treating physician or QHP; the psychiatric consultant’s services are included in the codes.
The treating physician pays the psychiatric consultant through a contractual arrangement.
If 45 to 74 minutes is spent, code 99498 should be assigned in addition to code 99497.