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Select Note Type
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Room Number
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Telehealth (Video on)
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Phone Call Visit (No video)
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Time
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Chief Complaint
• • •
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Chief Complaint Comments:
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History of Present Illness
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HPI Free Text
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Interval History
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Interval History Free Text
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Past Psychiatric History
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Past Psych History
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Past Psych History Comments:
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Past Medical/Surgical History
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Cardiac
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Endocrine
• • •
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GI/Renal
• • •
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GU
• • •
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HEENT
• • •
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Hematologic
• • •
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Pulmonary
• • •
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Musculoskeletal
• • •
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Neurological
• • •
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Cancer
• • •
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Medical History Comments
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Current Medications
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Medication & Dosage Specifications
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GDR
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Allergies
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Side effects
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Side Effects Comments:
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Patient is Compliant With Medications:
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Social History
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Marital Status
• • •
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Children
• • •
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Work Status
• • •
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Other
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Family Psychiatric History
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Family Hx
• • •
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Other:
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Substance Abuse History
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Substance Abuse History
• • •
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Substance History Abuse Comments:
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Review of Systems
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Review of Systems
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Review of Systems Comments:
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A complete ROS was performed and the patient endorsed the following::
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Constitutional
• • •
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HEENT
• • •
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Cardiovascular
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Respiratory
• • •
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Gastrointestinal
• • •
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Genitourinary
• • •
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Endocrine
• • •
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Hematology/Oncology
• • •
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Musculoskeletal
• • •
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Infectious Disease
• • •
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Integumentary
• • •
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Neurologic
• • •
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All other systems were reviewed and are negative
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Vital Signs
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BP
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P
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Wt
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Other
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Mental Status Exam
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Attitude
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Attitude Comments:
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Appearance
• • •
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Appearance Comments:
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Behavior
• • •
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Behavior Comments:
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Speech
• • •
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Speech Comments:
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Gait
• • •
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Gait Comments:
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Mood:
• • •
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Mood Comments:
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Affect:
• • •
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Affect Comments:
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Thought process:
• • •
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Thought Process Comments:
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Thought Content:
• • •
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Thought Content Comments:
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Suicidality:
• • •
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Suicidality Comments:
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Homicidality:
• • •
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Homicidality Comments:
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Sleep
• • •
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Sleep Comments:
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Energy
• • •
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Energy Comments:
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Appetite
• • •
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Appetite Comments:
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Orientation:
• • •
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Orientation Comments:
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Recall
• • •
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Recall Comments:
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Attention ("WORLD" backwards)
• • •
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Attention ("WORLD" backwards) Comments:
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Calculation (Serial 7s)
• • •
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Calculation Comments:
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Abstractions
• • •
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Abstractions Comments:
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Insight/Judgement:
• • •
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Insight/Judgement Comments:
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Labs
• • •
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Lab Comments:
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Test Results
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Patient Health Questionnaire - PHQ9
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Over the last 2 weeks, how often have you been bothered by any of the following symptoms?
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1.Little interest or pleasure in doing things
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6.Feeling bad about yourself – or that you are a failure or have let yourself or your family down
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2.Feeling down, depressed or hopeless
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7.Trouble concentration on things, such as reading the newspaper or watching television
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3.Trouble falling asleep or staying asleep or sleeping too much
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8.Moving/speaking so slowly that others could have noticed? Or the opposite being so fidgety/restless that you move more
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4.Feeling tired or having little energy
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9.Thoughts that you would be better off dead or of hurting yourself in some way
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5.Poor appetite or overeating
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PHQ-9 Score
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Date
|
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AIMS Assessment
|
|
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Facial movement
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Extremities movement
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Trunk movement
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Globe no movement and no incapacity from movement
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Date
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Capacity Assesment
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Does the patient have capacity?
|
Capacity date and elaboration:
|
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Primary Diagnosis (REQUIRED)*
|
|
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Adjustment Disorders
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|
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Adjustment Disorder
|
Dx Free Text
|
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With Depressed Mood - F43.21
|
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With Anxiety - F43.22
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With Anxiety and Depressed Mood - F43.23
|
|
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With Disturbance of Conduct - F43.24
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With Disturbance of Emotions & Conduct - F43.25
|
|
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Depression/Mood Disorders
|
|
|
Depression/Mood Disorder
|
Dx Free Text
|
|
Major Depressive Disorder‚ recurrent‚ mild - F33.0
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|
Major Depressive Disorder‚ recurrent‚ moderate - F33.1
|
|
|
Major Depressive Disorder‚ recurrent‚ severe without psychotic features -F33.2
|
|
|
Major Depressive Disorder‚ recurrent‚ severe with psychotic features - F33.3
|
|
|
Major Depressive Disorder, recurrent, unspecified - F33.9
|
|
|
Major Depressive Disorder‚ Single Episode‚ mild - F32.0
|
|
|
Major Depressive Disorder‚ Single Episode‚ moderate - F32.1
|
|
|
Major Depressive Disorder‚ Single Episode without Psychotic Features - F32.2
|
|
|
Major Depressive Disorder‚ Single Episode with Psychotic Features - F32.3
|
|
|
Major Depressive Disorder‚ Single Episode‚ unspecified - F32.9
|
|
|
Dysthymic Disorder - F34.1
|
|
|
Substance Induced Mood Disorder - F19.94
|
|
|
Bipolar Disorders
|
|
|
Bipolar Disorder
|
Dx Free Text
|
|
Bipolar Disorder‚ Manic with Psychotic Features‚ Severe - F31.2
|
|
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Bipolar Disorder‚ Manic without Psychotic Features‚ Unspecified - F31.10
|
|
|
Bipolar Disorder‚ Depressed with Psychotic Features‚ Severe - F31.5
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|
|
Bipolar Disorder‚ Depressed without Psychotic Features‚ Severe - F31.4
|
|
|
Bipolar Disorder‚ Depressed‚ Mild - F31.31
|
|
|
Bipolar Disorder‚ Depressed‚ Moderate - F31.32
|
|
|
Bipolar Disorder‚ Mixed - F31.6
|
|
|
Cyclothymic Disorder - F34.0
|
|
|
Anxiety Disorders
|
|
|
Anxiety Disorder
|
Dx Free Text
|
|
Panic Disorder with Agoraphobia - F40.01
|
|
|
Panic Disorder without Agoraphobia - F41.0
|
|
|
Generalized Anxiety Disorder - F41.1
|
|
|
Social Anxiety Disorder - F40.10
|
|
|
Anxiety Disorder‚ Unspecified - F41.9
|
|
|
Other Mixed Anxiety Disorders - F41.3
|
|
|
Anxiety depression (mild or not persistent) - F41.8
|
|
|
Psychotic Disorders
|
|
|
Psychotic Disorder
|
Dx Free Text
|
|
Paranoid Schizophrenia - F20.0
|
|
|
Schizo-Affective Disorder - F25.9
|
|
|
Delusional Disorder - F22
|
|
|
Schizoaffective Disorder, Bipolar type - F25.0
|
|
|
Brief Psychotic Disorder - F23
|
|
|
Substance induced Psychotic Disorder - F19.959
|
|
|
Substance Use Disorders
|
|
|
Substance Use Disorder
|
Dx Free Text
|
|
Alcohol Use Disorder with Intoxication - F10.27
|
|
|
Alcohol Use Disorder with Withdrawal - F10.239
|
|
|
Opiate Use Disorder - F11.90
|
|
|
Nicotine Use Disorder - F17.200
|
|
|
Marijuana and Cocaine dependence
|
|
|
Dementia/Delirium
|
|
|
Dementia/Delirium
|
Dx Free Text
|
|
Delirium due to Medical Condition - F05
|
|
|
Delirium Due to Unknown Medication - F19.921
|
|
|
Major Neurocognitive Disorder due to Alcohol - F10.96
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ with behavioral disturbance - F03.91
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ without behavioral disturbance - F03.90
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ with Behavioral Disturbance - F01.51
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ without Behavioral Disturbance - F01.50
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) with behavioral disturbance - F02.81
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) without behavioral disturbance - F02.80
|
|
|
Mild Neurocognitive Disorder - G31.84
|
|
|
Major Neurocognitive disorder due to Alzheimers - Early Onset- G30.0
|
|
|
Major Neurocognitive disorder due to Alzheimers - Late Onset - G30.1
|
|
|
Major Neurocognitive disorder due to Alzheimers - Unspecified - G30.9
|
|
|
Major Neurocognitive Disorder due to Frontotemporal - G31.09
|
|
|
Major Neurocognitive Disorder due to Lewy Body Disease - G31.83
|
|
|
Major Neurocognitive Disorder due to Parkinson's with behavioral disturbance‚ G20‚ F02.81
|
|
|
Major Neurocognitive disorder due to Parkinsons without behavioral disturbance - G20‚ F02.80
|
|
|
Major Neurocognitive Disorder due to HIV - B20
|
|
|
Miscellaneous Diagnoses
|
|
|
Miscellaneous Diagnoses
|
Dx Free Text
|
|
Acute Stress Reaction - F43.11
|
|
|
Disappearance and death of family member - Z63.4
|
|
|
Post-Traumatic Stress Disorder‚ Acute - F43.11
|
|
|
Post-Traumatic Stress Disorder‚ Chronic - F43.12
|
|
|
Dissociative Identity Disorder - F44.81
|
|
|
ADHD‚ Predominantly Inattentive Type - F90.0
|
|
|
Impulse Control Disorder - F63.9
|
|
|
Intermittent Explosive Disorder - F63.81
|
|
|
Borderline Personality Disorder - F60.3
|
|
|
Hoarding Disorder - F42.3
|
|
|
Primary Insomnia - F51.01
|
|
|
Adjustment Insomnia - F51.02
|
|
|
Obsessive Compulsive Disorder - F42
|
|
|
Additional Diagnoses if applicable:
|
|
|
Secondary Diagnosis
|
|
|
Secondary Diagnosis
|
|
|
Adjustment Disorders
|
|
|
Adjustment Disorder
|
Dx Free Text
|
|
With Disturbance of Emotions & Conduct - F43.25
|
|
|
With Depressed Mood - F43.21
|
|
|
With Anxiety - F43.22
|
|
|
With Anxiety and Depressed Mood - F43.23
|
|
|
With Disturbance of Conduct - F43.24
|
|
|
Depression/Mood Disorders
|
|
|
Depression/Mood Disorder
|
Dx Free Text
|
|
Major Depressive Disorder‚ recurrent‚ mild - F33.0
|
|
|
Major Depressive Disorder‚ recurrent‚ moderate - F33.1
|
|
|
Major Depressive Disorder‚ recurrent‚ severe without psychotic features -F33.2
|
|
|
Major Depressive Disorder‚ recurrent‚ severe with psychotic features - F33.3
|
|
|
Major Depressive Disorder, recurrent, unspecified - F33.9
|
|
|
Major Depressive Disorder‚ Single Episode‚ mild - F32.0
|
|
|
Major Depressive Disorder‚ Single Episode‚ moderate - F32.1
|
|
|
Major Depressive Disorder‚ Single Episode without Psychotic Features - F32.2
|
|
|
Major Depressive Disorder‚ Single Episode with Psychotic Features - F32.3
|
|
|
Major Depressive Disorder‚ Single Episode‚ unspecified - F32.9
|
|
|
Dysthymic Disorder - F34.1
|
|
|
Substance Induced Mood Disorder - F19.94
|
|
|
Bipolar Disorders
|
|
|
Bipolar Disorder
|
Dx Free Text
|
|
Bipolar Disorder‚ Manic with Psychotic Features‚ Severe - F31.2
|
|
|
Bipolar Disorder‚ Manic without Psychotic Features‚ Unspecified - F31.10
|
|
|
Bipolar Disorder‚ Depressed with Psychotic Features‚ Severe - F31.5
|
|
|
Bipolar Disorder‚ Depressed without Psychotic Features‚ Severe - F31.4
|
|
|
Bipolar Disorder‚ Depressed‚ Mild - F31.31
|
|
|
Bipolar Disorder‚ Depressed‚ Moderate - F31.32
|
|
|
Bipolar Disorder‚ Mixed - F31.6
|
|
|
Cyclothymic Disorder - F34.0
|
|
|
Anxiety Disorders
|
|
|
Anxiety Disorder
|
Dx Free Text
|
|
Panic Disorder with Agoraphobia - F40.01
|
|
|
Panic Disorder without Agoraphobia - F41.0
|
|
|
Generalized Anxiety Disorder - F41.1
|
|
|
Social Anxiety Disorder - F40.10
|
|
|
Anxiety Disorder‚ Unspecified - F41.9
|
|
|
Other Mixed Anxiety Disorders - F41.3
|
|
|
Anxiety depression (mild or not persistent) - F41.8
|
|
|
Psychotic Disorders
|
|
|
Psychotic Disorder
|
Dx Free Text
|
|
Paranoid Schizophrenia - F20.0
|
|
|
Schizo-Affective Disorder - F25.9
|
|
|
Delusional Disorder - F22
|
|
|
Schizoaffective Disorder, Bipolar type - F25.0
|
|
|
Brief Psychotic Disorder - F23
|
|
|
Substance induced Psychotic Disorder - F19.959
|
|
|
Substance Use Disorders
|
|
|
Substance Use Disorder
|
Dx Free Text
|
|
Alcohol Use Disorder with Intoxication - F10.27
|
|
|
Alcohol Use Disorder with Withdrawal - F10.239
|
|
|
Opiate Use Disorder - F11.90
|
|
|
Nicotine Use Disorder - F17.200
|
|
|
Marijuana and Cocaine dependence
|
|
|
Dementia/Delirium
|
|
|
Dementia/Delirium
|
Dx Free Text
|
|
Delirium due to Medical Condition - F05
|
|
|
Delirium Due to Unknown Medication - F19.921
|
|
|
Major Neurocognitive Disorder due to Alcohol - F10.96
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ with behavioral disturbance - F03.91
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ without behavioral disturbance - F03.90
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ with Behavioral Disturbance - F01.51
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ without Behavioral Disturbance - F01.50
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) with behavioral disturbance - F02.81
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) without behavioral disturbance - F02.80
|
|
|
Mild Neurocognitive Disorder - G31.84
|
|
|
Major Neurocognitive disorder due to Alzheimers - Early Onset- G30.0
|
|
|
Major Neurocognitive disorder due to Alzheimers - Late Onset - G30.1
|
|
|
Major Neurocognitive disorder due to Alzheimers - Unspecified - G30.9
|
|
|
Major Neurocognitive Disorder due to Frontotemporal - G31.09
|
|
|
Major Neurocognitive Disorder due to Lewy Body Disease - G31.83
|
|
|
Major Neurocognitive Disorder due to Parkinson's with behavioral disturbance‚ G20‚ F02.81
|
|
|
Major Neurocognitive disorder due to Parkinsons without behavioral disturbance - G20‚ F02.80
|
|
|
Major Neurocognitive Disorder due to HIV - B20
|
|
|
Miscellaneous Diagnoses
|
|
|
Miscellaneous Diagnoses
|
Dx Free Text
|
|
Acute Stress Reaction - F43.11
|
|
|
Disappearance and death of family member - Z63.4
|
|
|
Post-Traumatic Stress Disorder‚ Acute - F43.11
|
|
|
Post-Traumatic Stress Disorder‚ Chronic - F43.12
|
|
|
Dissociative Identity Disorder - F44.81
|
|
|
ADHD‚ Predominantly Inattentive Type - F90.0
|
|
|
Impulse Control Disorder - F63.9
|
|
|
Intermittent Explosive Disorder - F63.81
|
|
|
Borderline Personality Disorder - F60.3
|
|
|
Hoarding Disorder - F42.3
|
|
|
Primary Insomnia - F51.01
|
|
|
Adjustment Insomnia - F51.02
|
|
|
Obsessive Compulsive Disorder - F42
|
|
|
Tertiary Diagnosis
|
|
|
Tertiary Diagnosis
|
|
|
Adjustment Disorders
|
|
|
Adjustment Disorder
|
Dx Free Text
|
|
With Depressed Mood - F43.21
|
|
|
With Anxiety - F43.22
|
|
|
With Anxiety and Depressed Mood - F43.23
|
|
|
With Disturbance of Conduct - F43.24
|
|
|
With Disturbance of Emotions & Conduct - F43.25
|
|
|
Depression/Mood Disorders
|
|
|
Depression/Mood Disorder
|
Dx Free Text
|
|
Major Depressive Disorder‚ recurrent‚ mild - F33.0
|
|
|
Major Depressive Disorder‚ recurrent‚ moderate - F33.1
|
|
|
Major Depressive Disorder‚ recurrent‚ severe without psychotic features -F33.2
|
|
|
Major Depressive Disorder‚ recurrent‚ severe with psychotic features - F33.3
|
|
|
Major Depressive Disorder, recurrent, unspecified - F33.9
|
|
|
Major Depressive Disorder‚ Single Episode‚ mild - F32.0
|
|
|
Major Depressive Disorder‚ Single Episode‚ moderate - F32.1
|
|
|
Major Depressive Disorder‚ Single Episode without Psychotic Features - F32.2
|
|
|
Major Depressive Disorder‚ Single Episode with Psychotic Features - F32.3
|
|
|
Major Depressive Disorder‚ Single Episode‚ unspecified - F32.9
|
|
|
Dysthymic Disorder - F34.1
|
|
|
Substance Induced Mood Disorder - F19.94
|
|
|
Bipolar Disorders
|
|
|
Bipolar Disorder
|
Dx Free Text
|
|
Bipolar Disorder‚ Manic with Psychotic Features‚ Severe - F31.2
|
|
|
Bipolar Disorder‚ Manic without Psychotic Features‚ Unspecified - F31.10
|
|
|
Bipolar Disorder‚ Depressed with Psychotic Features‚ Severe - F31.5
|
|
|
Bipolar Disorder‚ Depressed without Psychotic Features‚ Severe - F31.4
|
|
|
Bipolar Disorder‚ Depressed‚ Mild - F31.31
|
|
|
Bipolar Disorder‚ Depressed‚ Moderate - F31.32
|
|
|
Bipolar Disorder‚ Mixed - F31.6
|
|
|
Cyclothymic Disorder - F34.0
|
|
|
Anxiety Disorders
|
|
|
Anxiety Disorder
|
Dx Free Text
|
|
Panic Disorder with Agoraphobia - F40.01
|
|
|
Panic Disorder without Agoraphobia - F41.0
|
|
|
Generalized Anxiety Disorder - F41.1
|
|
|
Social Anxiety Disorder - F40.10
|
|
|
Anxiety Disorder‚ Unspecified - F41.9
|
|
|
Other Mixed Anxiety Disorders - F41.3
|
|
|
Anxiety depression (mild or not persistent) - F41.8
|
|
|
Psychotic Disorders
|
|
|
Psychotic Disorder
|
Dx Free Text
|
|
Paranoid Schizophrenia - F20.0
|
|
|
Schizo-Affective Disorder - F25.9
|
|
|
Delusional Disorder - F22
|
|
|
Schizoaffective Disorder, Bipolar type - F25.0
|
|
|
Brief Psychotic Disorder - F23
|
|
|
Substance induced Psychotic Disorder - F19.959
|
|
|
Substance Use Disorders
|
|
|
Substance Use Disorder
|
Dx Free Text
|
|
Alcohol Use Disorder with Intoxication - F10.27
|
|
|
Alcohol Use Disorder with Intoxication - F10.27
|
|
|
Opiate Use Disorder - F11.90
|
|
|
Nicotine Use Disorder - F17.200
|
|
|
Marijuana and Cocaine dependence
|
|
|
Dementia/Delirium
|
|
|
Dementia/Delirium
|
Dx Free Text
|
|
Delirium due to Medical Condition - F05
|
|
|
Delirium Due to Unknown Medication - F19.921
|
|
|
Major Neurocognitive Disorder due to Alcohol - F10.96
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ with behavioral disturbance - F03.91
|
|
|
Major Neurocognitive Disorder‚ Unspecified‚ without behavioral disturbance - F03.90
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ with Behavioral Disturbance - F01.51
|
|
|
Major Neurocognitive Disorder‚ Vascular‚ without Behavioral Disturbance - F01.50
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) with behavioral disturbance - F02.81
|
|
|
Major Neurocognitive Disorder (in diseases specified elsewhere) without behavioral disturbance - F02.80
|
|
|
Mild Neurocognitive Disorder - G31.84
|
|
|
Major Neurocognitive disorder due to Alzheimers - Early Onset- G30.0
|
|
|
Major Neurocognitive disorder due to Alzheimers - Late Onset - G30.1
|
|
|
Major Neurocognitive disorder due to Alzheimers - Unspecified - G30.9
|
|
|
Major Neurocognitive Disorder due to Frontotemporal - G31.09
|
|
|
Major Neurocognitive Disorder due to Lewy Body Disease - G31.83
|
|
|
Major Neurocognitive Disorder due to Parkinson's with behavioral disturbance‚ G20‚ F02.81
|
|
|
Major Neurocognitive disorder due to Parkinsons without behavioral disturbance - G20‚ F02.80
|
|
|
Major Neurocognitive Disorder due to HIV - B20
|
|
|
Miscellaneous Diagnoses
|
|
|
Miscellaneous Diagnoses
|
Dx Free Text
|
|
Acute Stress Reaction - F43.11
|
|
|
Disappearance and death of family member - Z63.4
|
|
|
Post-Traumatic Stress Disorder‚ Acute - F43.11
|
|
|
Post-Traumatic Stress Disorder‚ Chronic - F43.12
|
|
|
Dissociative Identity Disorder - F44.81
|
|
|
ADHD‚ Predominantly Inattentive Type - F90.0
|
|
|
Impulse Control Disorder - F63.9
|
|
|
Intermittent Explosive Disorder - F63.81
|
|
|
Borderline Personality Disorder - F60.3
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Hoarding Disorder - F42.3
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Primary Insomnia - F51.01
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Adjustment Insomnia - F51.02
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Obsessive Compulsive Disorder - F42
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Treatment Plan / Recommendations
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Plan:
• • •
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Did you refer for psychotherapy?
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Other Reason:
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Antipsychotic Medication:
• • •
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Other:
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This visit includes supportive psychotherapy services
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Time spent counseling patient
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Appointment Length:
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Additional supportive psychotherapy interventions
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Interventions Used*
• • •
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MIPS - please answer all 9 measures
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MIPS CPT Code
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Depression Screening and Follow Up (measure #134)
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*Existing Diagnosis of Depression or Bipolar Disorder
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*Positive Screening and Follow Up Documented
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*N/A - Negative Screening No Follow Up Needed
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Patient Declined Interview and Services
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Elder Maltreatment Screen and Follow Up (measure #181)
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*Negative Screening No Follow Up Needed
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*Positive Screening and Follow Up Documented
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*Patient Not Eligible
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No Screening Performed
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Reason
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Dementia Associated Symptoms Screening and Management (measure #283)
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*Positive Screening Recommendations Documented
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No Screening Performed
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*N/A - Negative Screening No Plan Needed
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Dementia: Safety Screening and Follow Up (measure #286)
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*Positive Screening and Safety Pamphlet Provided
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*Patient Unable to Communicate
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*N/A - Negative Screening No Education Needed
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No Screening No Reason Documented
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Dementia: Education and Support for Caregivers (measure #288)
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*Education and Support References Provided
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*No Education/Support Provided Reason Documented
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*N/A - Negative Screening. No Education Needed
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No Education/Support Provided No Reason Documented
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Adherence to Medications (measure #383)
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*Patient is adhering to antipsychotic medications as prescribed OR HAS NO PSYCHOTIC SYMPTOMS
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*Patient is non compliant with antipsychotic medication that has been prescribed
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Documentation of Current Meds (measure #130)
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*Medications documented in patient's facility chart
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*Patient not Eligible
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Meds Not Documented
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Advance Care Plan (measure #47)
|
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*Provided by facility - see advance directive section in chart
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N/A - Patient under 65. No Care Plan Needed
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Dementia: Functional Status Assessment (measure #282)
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*Functional Status Performed (BIMS or MMSE) in last 12 months
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*No Assessment Reason Documented
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No Assessment No Reason Given
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Billing
|
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99305
|
Appointment Length:
|
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99306
|
|
|
99308
|
|
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99309
|
|
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99310
|
|
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99325 AL Intake
|
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99326 AL Intake
|
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99327 AL Intake
|
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99334 AL F/U
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99335 AL F/U
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99336 AL F/U
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99343 IL Intake 45 min
|
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99344 IL Intake 45 min
|
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99348 IL F/U 25 min
|
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99349 IL F/U 40 min
|
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99350 IL F/U 60 min
|
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99214 IL F/U
|
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99215 IL F/U
|
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90785 Interactive Complexity add on code
|
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90839 Crisis Intervention
|
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90840 Crisis Intervention
|
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Medicaid Only Follow up 99252
|
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Medicaid Only Follow up 99253
|
|
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Medicaid Follow up Only 99254
|
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90833
|
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90836
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