New medical psychotherapy CPT coding: the tail wagging the dog?

The implications of the 2013 revised Current Procedural Terminology (CPT) system for coding psychotherapy with medical evaluation and management (E&M) are discussed. The author expresses concern about a potential devaluing of psychotherapy because of the required order of reporting combined codes, with E&M the primary code. Procedural and documentation requirements for using the standard medical E&M codes challenge psychiatrists to be systematic and efficient in order not to interfere with time and attention essential to an effective psychotherapy process. Insensitive use of computers when working with patients can damage rapport and progress. The trend toward sharing personal health information in large systems calls for heightened discretion. Using the psychotherapy notes protected under the Health Insurance Portability and Accountability Act (HIPAA) for highly sensitive personal information is essential to preserve patient privacy. (Journal of Psychiatric Practice 2013;19:150-151)