What category of codes should be used to report an evaluation and management service provided to a patient in a psychiatric residential treatment center?

What category of codes should be used to report an evaluation and management service provided to a patient in a psychiatric residential treatment center?

• A. Domiciliary, rest home or custodial care
• B. Observation services
• C. Nursing facility services
• D. Hospital inpatient services

Answer: (C)

Reporting an evaluation and management service in a psychiatric residential treatment center uses the nursing facility services category. These centers are long-term residential care settings with ongoing medical and therapeutic supervision, so the E/M codes that apply are the nursing facility codes designed for encounters in such facilities. The other categories don’t fit this setting: domiciliary/rest home or custodial care codes are meant for non-skilled, home-like environments; observation services are for patients in hospital observation; and hospital inpatient services are for patients admitted to a hospital. The exact nursing facility codes you choose depend on whether it’s an initial visit to the facility or a subsequent visit, and on documentation of history, exam, and medical decision making.

Reporting an evaluation and management service in a psychiatric residential treatment center uses the nursing facility services category. These centers are long-term residential care settings with ongoing medical and therapeutic supervision, so the E/M codes that apply are the nursing facility codes designed for encounters in such facilities. The other categories don’t fit this setting: domiciliary/rest home or custodial care codes are meant for non-skilled, home-like environments; observation services are for patients in hospital observation; and hospital inpatient services are for patients admitted to a hospital. The exact nursing facility codes you choose depend on whether it’s an initial visit to the facility or a subsequent visit, and on documentation of history, exam, and medical decision making.