What is Psychiatric Coding?

Psychiatric coding is the practice of medical billing and coding, applied to psychiatric, mental, and behavioral health.

Psychiatric coders work in inpatient or outpatient settings, helping to codify mental health conditions like bipolar disorder, depression, schizophrenia, and suicidal ideation. Work with patients who are going through detoxification or addiction rehabilitation work is common as well.

Where do psychiatric coders work?

Psychiatric coders often work in small clinical practice or hospital settings.

In a small clinical setting, coders work directly with psychiatrists and other mental health professionals at the clinic to properly code and bill insurance for the treatment patients receive, like psychotherapy or psychoactive medications. This is typically referred to as "outpatient" psychiatric coding.

In a hospital setting that may do longer-term work for addiction, depression, or rehabilitation, coders work within the larger team of hospital staff to correctly itemize and bill for the treatment received. This is commonly referred to as "inpatient" psychiatric coding.

How is psychiatric coding different from standard medical coding?

The main difference between medical coding and psychiatric coding is the subject matter.

In medical coding, billers and coders usually deal with conditions and diseases of the body, including surgeries, diagnoses, and medications.

In psychiatric coding, coders usually deal with conditions and diseases of the mind. This means that more treatment is focused on services, such as psychotherapy for the treatment of depression, and medications, such as antidepressants, antipsychotics, and mood stabilizers.

Psychiatric billing focuses more on the services and medications needed to treat the mind, rather than the surgical procedures commonly used to treat the body.

What do I need to know to be a psychiatric coder or biller?

According to current practitioners, having a basic understanding of behavioral health helps a lot.

For example, understanding the differences between depression, bipolar disorder, anxiety, panic disorder, OCD, and schizophrenia will help give you an understanding of what exactly it is you will deal with every day.

Additionally, understanding the types of medications prescribed will help you understand the procedures typically used for each condition.

What types of psychiatric medications are there?

There are five main types of psychotropic medications: antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers.

Let's look at how each one is used.

Antidepressants are used to treat depression

Antidepressants, like Prozac and Lexapro, are used to treat depression. They work by increasing the amount of certain brain chemicals (like serotonin, dopamine, and norepinephrine) that your brain needs to function properly.

Anti-anxiety medication is used to treat chronic (consistent) or acute (sudden) anxiety

Anti-anxiety medications like Xanax, Valium, and Ativan, are used to treat the effects of anxiety. These include panic attacks, phobias, generalized anxiety, and persistent stress.

Stimulants help improve concentration and promote a sense of calm

Stimulants, like Adderall, Dexadrine, Ritalin, or Vyvanse, help patients concentrate by providing general stimulation to the brain and body. By increasing stimulation, patients are better able to focus and manage complex tasks, like managing their day or projects, and stressful tasks, like having a difficult conversation with a family member.

Anti-psychotics help with hallucination and delusion

Some patients display signs of detachment from reality, or persistent illusions about themselves or others that make it difficult to interact with others or focus on their daily lives. For these patients, anti-psychotic medication can help calm the patient, allow them to think more clearly, and begin to distinguish reality from what is in their head. This often takes the form of clearer communication with care providers, family, and others.

Mood stabilizers are used to treat bipolar disorder

Mood stabilizers help restrict the range and "peaks" of emotions that people feel. For patients with sudden mood swings, or persistent episodes of mania or extreme depression, mood stabilizers may help regulate these emotions within a more normal range. This helps the patient feel more normal, "even", and consistent in their behavior, so they can establish a consistency in their lives.

Does psychiatric coding pay as well as medical coding?

Yes, it does! As specialized work, psychiatric coding pays just as well as standard medical billing and coding, and often more. Because the field is smaller and more specialized, there are often fewer positions in psychiatric billing and coding than the field at large, and those positions may be highly paid due to the lack of qualified applicants.

Is psychiatric coding and billing growing like standard medical coding is?

Yes! The behavioral and mental health industry itself is set to grow at 25% over the next five years (GlobalNewsWire, 2022). As the industry itself grows, there will be increased demand for billers and coders in the field, especially specialized practitioners who specifically understand behavioral health, and have experience working in these settings. Starting now is a great idea, because you will be at the forefront of the field (and the pay structure), as the industry grows.